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. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

• A. Send the child to his or her room if the child has one.
• B. A general rule for length of time is 1 hour per year of age.
• C. Select an area that is safe and nonstimulating, such as a hallway.
• D. If the child cries, refuses, or is more disruptive, try another approach.

Correct answer: C

Rationale: Time-outs should be in a safe, nonstimulating area, with the length typically being 1 minute per year of the child's age, not 1 hour.

3. The mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils and adenoids complains that he has begun sucking his thumb again. Which defense mechanism should the nurse include when responding to the mother?

• A. Repression
• B. Regression
• C. Rationalization
• D. Fantasy

Correct answer: B

Rationale: The correct answer is B: Regression. Regression is a common defense mechanism where a child reverts to an earlier stage of development, such as thumb-sucking, to cope with stress. In this scenario, the 6-year-old boy is using thumb-sucking (a behavior typical of earlier developmental stages) as a way to deal with the stress of surgery. Repression (choice A) involves unconsciously blocking out thoughts or feelings, which is not applicable in this case. Rationalization (choice C) is a defense mechanism where illogical or unreasonable explanations are provided to justify behavior, which is not relevant here. Fantasy (choice D) refers to the use of imagination to escape from reality, which is also not the appropriate defense mechanism for the situation described.

4. Prior to giving a hospitalized pre-schooler an injection, the nurse gives the child’s teddy bear a “shot” first. This method is known as:

• A. Critical play
• B. Role play
• C. Diversionary activity
• D. Dramatic play

Correct answer: D

Rationale: The correct answer is D: Dramatic play. Dramatic play involves children acting out experiences to better understand them and reduce fear. In this scenario, by giving the teddy bear a 'shot' first, the nurse is engaging in dramatic play to help the child comprehend and feel more comfortable with the upcoming injection.\n A: Critical play involves critical thinking and problem-solving, not acting out scenarios.\n B: Role play typically involves pretending to be someone else, not necessarily acting out a specific experience.\n C: Diversionary activity aims to distract or redirect attention, which is different from the purpose of dramatic play in this context.

5. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)

• A. Lightly brush the palate with a cotton swab
• B. Perform the examination in front of a mirror
• C. Let the child examine someone else's mouth first
• D. All of the above

Correct answer: D

Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.

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