Nursing Elites

1. Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?

• A. ''We're glad the dog can continue to sleep in our child’s room.''
• B. ''We’ll keep the plants in our child’s room dusted.''
• C. ''We’ll be sure to use the fireplace often to keep the house warm in the winter.''
• D. ''We will replace the carpet in our child’s bedroom with a hard surface.''

Correct answer: D

Rationale: The correct answer is D. Replacing carpet with hard flooring helps to reduce allergens and asthma triggers in the child’s environment. Choice A is incorrect as having a dog in the child’s room can worsen asthma symptoms due to pet dander. Choice B is incorrect because keeping plants in the child’s room can increase mold spores and allergens. Choice C is incorrect as using a fireplace can introduce smoke and other irritants into the air, worsening asthma symptoms.

2. While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?

• A. The 6-month-old in deep sleep
• B. The 2-year-old who is cooperative when the nurse takes vital signs
• C. The 4-year-old who is actively watching cartoons
• D. The 14-month-old who is screaming and thrashing his arms and legs

Correct answer: D

Rationale: The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.

3. What is an important priority in dealing with the child suspected of having Wilms tumor?

• A. Intervening to minimize bleeding
• B. Monitoring temperature for infection
• C. Ensuring the abdomen is protected from palpation
• D. Teaching parents how to manage parenteral nutrition

Correct answer: C

Rationale: The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.

4. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, "I want to go back to work, but I don't want Eric to suffer because I'll have less time with him." Which is the nurse's most appropriate answer?

• A. "I'm sure he'll be fine if you get a good babysitter."
• B. "You will need to stay home until Eric starts school."
• C. "Let's talk about the childcare options that will be best for Eric."
• D. "You should go back to work so Eric will get used to being with others."

Correct answer: C

Rationale: The best approach is to discuss childcare options that would suit Eric's needs, allowing the mother to make an informed decision without guilt or pressure.

5. What is the leading cause of morbidity and mortality in children with cystic fibrosis?

• A. Respiratory infections
• B. Malnutrition
• C. Diabetes
• D. Liver disease

Correct answer: A

Rationale: Respiratory infections are the leading cause of morbidity and mortality in children with cystic fibrosis. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which predisposes these children to recurrent respiratory infections. Malnutrition and diabetes are common comorbidities in cystic fibrosis but are not the leading causes of morbidity and mortality in affected children. Liver disease can occur in cystic fibrosis but is less common than respiratory complications.

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