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 working with a couple at risk of bearing a child with a genetic abnormality, what is most important for the nurse to incorporate into the plan of care?

• A. Gathering information from at least three generations
• B. Informing the couple of the need for a wide range of information
• C. Maintaining the confidentiality of the information
• D. Presenting the information in a nondirective manner

Correct answer: D

Rationale: When counseling a couple at risk of genetic abnormalities, it is crucial to present information in a nondirective manner. This approach allows the couple to make informed decisions without feeling pressured or influenced. Gathering information from at least three generations (Choice A) may be relevant for genetic counseling but is not the most critical aspect in this scenario. Informing the couple of the need for a wide range of information (Choice B) is too general and does not address the specific approach needed in this situation. Maintaining the confidentiality of the information (Choice C) is important but not the top priority compared to presenting information in a nondirective manner.

3. A parent asks the nurse what to do when their toddler has temper tantrums. What play materials should the nurse suggest to offer the child as another way of expressing anger?

• A. Ball and bat
• B. Wad of clay
• C. Punching bag
• D. Pegs and pounding board

Correct answer: D

Rationale: Pegs and pounding boards are the most suitable choice for toddlers to express their emotions constructively. These materials provide a safe and acceptable way for toddlers to release anger and frustration through physical activity. Options A, B, and C may not be as effective or safe for toddlers dealing with temper tantrums. A ball and bat may encourage aggressive behavior rather than constructive expression. A wad of clay might not be ideal for channeling anger, and a punching bag can potentially promote violent behavior, which is not appropriate for toddlers.

4. A parent receives a note from the school that a student in class has head lice. The parent calls the school nurse to ask how to check for head lice. What instructions should the nurse provide?

• A. Ask the child where it itches.
• B. Check to see if your dog has ear mites.
• C. Look along the scalp line for white dots.
• D. Observe between the fingers for red lines.

Correct answer: C

Rationale: The correct answer is to look along the scalp line for white dots (nits) when checking for head lice. White dots are indicative of head lice infestation. Itching alone, as mentioned in choice A, is not a reliable indicator of head lice. Choice B is irrelevant as it refers to checking for ear mites in a dog, not head lice in a human. Observing between the fingers for red lines, as in choice D, is not a method to check for head lice.

5. A nurse is caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS). What is most important for the nurse to assess?

• A. Quality of the cry
• B. Signs of dehydration
• C. Coughing up feedings
• D. Characteristics of the stool

Correct answer: B

Rationale: The correct answer is B: Signs of dehydration. Assessing for signs of dehydration is crucial in infants with hypertrophic pyloric stenosis (HPS) because they are at high risk due to frequent vomiting. Dehydration can lead to serious complications if not promptly addressed. Choices A, C, and D are not the priority assessments for HPS. While the quality of the cry can provide some information on the infant's distress level, dehydration assessment takes precedence. Coughing up feedings may not be specific to HPS, and characteristics of the stool, although important in general assessments, are not the priority in this situation.

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