Nursing Elites

1. You are developing a plan of care for a hospitalized child. Which age group is most likely to view illness as a punishment for misdeeds?

• A. Adolescence
• B. Preschool age
• C. Infancy
• D. School age

Correct answer: B

Rationale: Preschool-aged children often engage in magical thinking, where they may believe that illness is a punishment for misdeeds. This belief is related to their cognitive development stage, where they may attribute cause and effect in a magical or unrealistic way. Adolescents are more likely to view illness as a disruption to their sense of independence or control. Infants lack the cognitive development to associate illness with punishment for misdeeds. School-aged children typically have a more concrete understanding of illness and its causes, moving away from magical thinking.

2. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?

• A. Ask her why she wants to know.
• B. Determine why she is so anxious.
• C. Explain in simple terms how it works.
• D. Tell her she will see how it works as it is used.

Correct answer: C

Rationale: Providing a simple explanation satisfies the child's curiosity and helps reduce any anxiety about the procedure.

3. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?

• A. Acute diarrhea and dehydration
• B. Current jelly-like stools and pain
• C. Failure to pass meconium and abdominal distension
• D. Projectile vomiting and altered electrolytes

Correct answer: C

Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.

4. A child who weighs 10 kg is to receive Motrin 8 mg/kg po q4h prn for pain. The label reads 100 mg/5 mL. How much will you administer?

• A. 4 mL
• B. 2 mL
• C. 5 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage, multiply the child's weight (10 kg) by the dosage (8 mg/kg) which equals 80 mg. Since the concentration is 100 mg/5 mL, to find out how much to administer, you need to determine how many 5 mL doses are in 80 mg. It will be 80 mg ÷ 100 mg * 5 mL = 4 mL. Therefore, the correct answer is 4 mL. Choice B, 2 mL, is incorrect because it does not account for the correct dosage calculation. Choice C, 5 mL, is incorrect as it does not consider the dosage based on the child's weight. Choice D, 3 mL, is incorrect as it does not reflect the accurate dosage calculation.

5. When teaching a discipline class for parents of pre-schoolers, the nurse will be guided by which principle?

• A. Using the strictest form of punishment at the time of infraction is most effective
• B. Punishment increases unwanted behavior
• C. Discipline is to teach and gradually shift control from parents to child, promoting self-discipline
• D. Discipline and punishment are the same

Correct answer: C

Rationale: The correct principle to guide the nurse when teaching a discipline class for parents of pre-schoolers is that discipline is meant to teach and gradually shift control from parents to the child, promoting self-discipline. This approach focuses on educating children on appropriate behavior rather than solely relying on punishment. Choice A is incorrect because using the strictest punishment is not the most effective method for discipline. Choice B is incorrect because punishment can reinforce unwanted behavior if not used appropriately. Choice D is incorrect because discipline and punishment are not synonymous; discipline involves a broader aspect of teaching and guiding behavior.

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