Nursing Elites

1. Which situation denotes a nontherapeutic nurse-patient-family relationship?

• A. The nurse is planning to read a favorite fairy tale to a patient
• B. During shift report, the nurse is criticizing parents for not visiting their child
• C. The nurse is discussing with a fellow nurse the emotional draw to a certain patient
• D. The nurse is working with a family to find ways to decrease the family’s dependence on health care providers

Correct answer: B

Rationale: Criticizing parents or making negative comments about their involvement is nontherapeutic and can damage the nurse-patient-family relationship.

2. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

• A. The antibiotic therapy contributes to labile blood pressure values.
• B. Hypotension leading to sudden shock can develop at any time.
• C. Acute hypertension is a concern that requires monitoring.
• D. Blood pressure fluctuations indicate that the condition has become chronic.

Correct answer: C

Rationale: Acute hypertension is a common complication of acute glomerulonephritis, requiring frequent monitoring to prevent complications such as encephalopathy or heart failure. Blood pressure fluctuations can occur but are not necessarily indicative of chronic disease.

3. The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?

• A. Place the child in the Trendelenburg position.
• B. Apply moist heat to the abdomen.
• C. Allow the child to assume a position of comfort.
• D. Administer a saline enema to cleanse the bowel.

Correct answer: C

Rationale: Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.

4. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?

• A. The United States is ranked last among 27 countries
• B. The United States is ranked similar to 20 other developed countries
• C. The United States is ranked in the middle of 20 other developed countries
• D. The United States is ranked highest among 27 other industrialized countries

Correct answer: A

Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.

5. Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?

• A. Meperidine (Demerol)
• B. Morphine
• C. Acetaminophen (Tylenol)
• D. Ibuprofen (Motrin)

Correct answer: B

Rationale: In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.

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