Nursing Elites

1. Where is the most appropriate location to perform a procedure on a preschooler?

• A. Perform the procedure in the child's hospital bed.
• B. Perform the procedure in the treatment room.
• C. Allow the child to decide when the procedure will be performed.
• D. Ask the parents to help restrain the child so the procedure can be performed.

Correct answer: B

Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.

2. When assessing a 6-year-old boy with pain in the right lower quadrant of his abdomen, which action should be performed first?

• A. Avoiding palpation of the abdomen.
• B. Palpating the right lower quadrant first.
• C. Auscultating bowel sounds for 2 minutes.
• D. Palpating the left upper quadrant first.

Correct answer: D

Rationale: Palpating the left upper quadrant first is the correct approach when assessing abdominal pain in a child. This method helps to minimize causing additional discomfort to the child and allows for a more accurate assessment of their reaction to palpation. By starting on the left upper quadrant, you can gauge the child's pain response before moving to the area of complaint, which may be more sensitive. This approach is essential for a thorough and less distressing abdominal assessment in pediatric patients.

3. The student nurse has performed a gestational age assessment of an infant and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment?

• A. Lanugo mostly gone, little vernix remaining on the body
• B. Prominent clitoris, enlarging labia minora, patent anus
• C. Full areola, 5 to 10 mm nipple bud, pinkish-brown areola
• D. Skin opaque, cracking at wrists and ankles, no visible vessels

Correct answer: B

Rationale: The correct answer is B. At 30 to 32 weeks' gestation, the clitoris is prominent, and the labia minora are enlarging. The labia majora are small and widely separated. As gestational age increases, the labia majora increase in size. At 36 to 40 weeks, they almost cover the clitoris. At 40 weeks and beyond, the labia majora cover the labia minora and clitoris. Choices A, C, and D do not align with the characteristic features seen at 32 weeks of gestation, making them incorrect.

4. In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?

• A. Central cyanosis
• B. Respiratory rate >70 breaths per minute
• C. Grunting noted on assessment
• D. All of the above

Correct answer: D

Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.

5. Which of the following statements regarding febrile seizures in children is correct?

• A. They can occur even after a child has had a fever for longer than 24 hours.
• B. They can be caused by viral or bacterial meningitis.
• C. They do not typically occur on the first day of a fever.
• D. They typically last less than 15 minutes and often do not have a postictal phase.

Correct answer: D

Rationale: The correct answer is D. Febrile seizures in children typically last less than 15 minutes and often do not have a postictal phase, meaning there is usually no prolonged recovery period or confusion after the seizure. They are commonly associated with the rapid rise in body temperature at the onset of a fever, rather than the duration of the fever itself. Choices A, B, and C are incorrect because febrile seizures can occur even after a child has had a fever for longer than 24 hours, they can be caused by viral or bacterial meningitis, and they do not have a typical pattern of occurring on the first day of a fever.

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