Nursing Elites

1. Which pediatric condition is most likely to present with a "whooping" sound during coughing?

• A. Croup
• B. Bronchitis
• C. Pertussis
• D. Asthma

Correct answer: C

Rationale: The correct answer is C: Pertussis. Pertussis, also known as whooping cough, is characterized by a "whooping" sound during coughing episodes. This distinctive sound is due to the rapid intake of air after a series of coughs. Choice A, Croup, typically presents with a barking cough and stridor. Choice B, Bronchitis, is characterized by a productive cough with mucus. Choice D, Asthma, usually presents with wheezing and shortness of breath.

2. What intervention is contraindicated in a suspected case of appendicitis?

• A. Enemas
• B. Palpating the abdomen
• C. Administration of antibiotics
• D. Administration of antipyretics for fever

Correct answer: A

Rationale: Enemas are contraindicated in cases of suspected appendicitis because they can increase the risk of perforation. The pressure from the enema can exacerbate inflammation and potentially lead to the rupture of the appendix. Palpating the abdomen gently is essential for diagnosing appendicitis, as it helps identify the characteristic signs like rebound tenderness. Antibiotics are commonly used to treat the infection associated with appendicitis, and antipyretics are administered to manage fever, which is a common symptom of the condition. Therefore, enemas are the intervention to avoid in suspected appendicitis cases.

3. 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.

4. An anxious 12-year-old child receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, 'Is it hard to give someone an injection?' This child’s question is evidence that the child has developed which cognitive skill?

• A. Conservation
• B. Accommodation
• C. Decentering
• D. Class inclusion

Correct answer: C

Rationale: The correct answer is C: Decentering. Decentering is the ability to consider multiple aspects of a situation, which the child's question demonstrates. In this scenario, the child's question shows that she is thinking beyond her own experience and considering the difficulty or complexity of giving an injection from the nurse's perspective. Choices A, B, and D are incorrect. Conservation refers to understanding that certain properties of an object remain the same despite changes in its appearance. Accommodation is the process of adjusting existing knowledge or creating new mental categories to incorporate new information. Class inclusion involves understanding the relationship between a whole set and its subsets, which is not demonstrated in the child's question.

5. A child with acetylsalicylic acid (aspirin) poisoning is being admitted to the emergency department. What early clinical manifestation does the nurse expect to assess on this child?

• A. Hematemesis
• B. Hematochezia
• C. Hyperglycemia
• D. Hyperventilation

Correct answer: D

Rationale: Early signs of aspirin poisoning include hyperventilation due to the stimulation of the respiratory center and the resultant respiratory alkalosis. Hematemesis, hematochezia, and hyperglycemia can occur later in the poisoning process or may not be directly related to aspirin toxicity.

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