Nursing Elites

1. You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation?

• A. inform the parents of your suspicions
• B. call the police so the parents can be arrested
• C. advise the parents that the child needs to be transported
• D. transport the child to the hospital regardless of the parents' wishes

Correct answer: C

Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported allows for the child to receive necessary medical care without immediate confrontation or escalating the situation. Calling the police to have the parents arrested without concrete evidence may not be appropriate and could further endanger the child. Informing the parents of suspicions may lead to interference or denial of necessary care. Transporting the child to the hospital is crucial, but involving and engaging with the parents in a non-confrontational manner is the initial step to ensure the child's safety and well-being.

2. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Meals should be eaten at home.
• B. Foods should be weighed using a gram scale.
• C. A ready source of glucose should be available.
• D. Specific foods should be cooked for the adolescent.

Correct answer: C

Rationale: The correct answer is C: A ready source of glucose should be available. When managing type 1 diabetes, it is crucial to have a quick source of glucose readily available in case of hypoglycemia. This ensures that the adolescent can quickly raise their blood sugar levels to prevent complications. Choices A, B, and D are incorrect as they do not address the immediate need for glucose in managing hypoglycemia. While it is important for meals to be consumed regularly and in a controlled manner, specifying that they should be eaten at home or foods weighed using a gram scale is not as critical as ensuring a quick source of glucose in emergency situations.

3. A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102°F, is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect the child has?

• A. Measles
• B. Chickenpox
• C. Fifth disease
• D. Scarlet fever

Correct answer: A

Rationale: The nurse should suspect measles in this child. The presence of a high fever, irritability, runny nose, rash, and Koplik spots (small, red spots with blue-white centers in the mouth) are classic signs of measles. Measles is a highly contagious viral illness that can lead to serious complications if not managed promptly. Chickenpox (choice B) presents with a different rash pattern and does not typically involve Koplik spots. Fifth disease (choice C) and scarlet fever (choice D) also have distinct clinical presentations and are not characterized by the specific symptoms described in this case.

4. When evaluating the laboratory report of a 1-year-old infant’s hematocrit, a healthcare professional compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?

• A. 19% to 32%
• B. 29% to 41%
• C. 37% to 47%
• D. 42% to 69%

Correct answer: C

Rationale: The correct answer is C: 37% to 47%. The normal hematocrit range for a 12-month-old infant is between 37% to 47%, which reflects the expected blood volume and red blood cell levels for this age. Choice A (19% to 32%) and Choice B (29% to 41%) are too low and do not encompass the typical hematocrit range for a healthy 1-year-old. Choice D (42% to 69%) is too high and falls outside the usual hematocrit values for this age group.

5. A 7-year-old child with a diagnosis of type 1 diabetes mellitus is under the care of a nurse. What is the priority nursing intervention?

• A. Administering insulin as prescribed
• B. Monitoring blood glucose levels
• C. Teaching the child how to self-administer insulin
• D. Encouraging regular exercise

Correct answer: B

Rationale: The priority nursing intervention for a 7-year-old child with type 1 diabetes mellitus is monitoring blood glucose levels. This is crucial for managing and adjusting insulin therapy to maintain blood glucose within the target range. Administering insulin as prescribed is important but should be based on monitoring blood glucose levels. Teaching the child how to self-administer insulin may be appropriate for older children but may not be the priority for a 7-year-old. Encouraging regular exercise is a valuable aspect of diabetes management but is not the immediate priority over monitoring blood glucose levels.

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