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. What changes could the school nurse implement at the school to help reduce students’ risk for developing type 2 diabetes?

• A. Increase the amount of daily physical activity.
• B. Decrease the amount of daily physical activity.
• C. Test each child’s urine monthly.
• D. Teach parents to avoid administering aspirin to their child.

Correct answer: A

Rationale: Increasing physical activity helps improve insulin sensitivity and can prevent or delay the onset of type 2 diabetes in children. Regular physical activity is a key component in managing weight and reducing the risk of chronic diseases. Decreasing physical activity (Choice B) would not be beneficial in reducing the risk of type 2 diabetes. Testing each child’s urine monthly (Choice C) is not directly related to preventing type 2 diabetes. Teaching parents to avoid administering aspirin to their child (Choice D) is important for Reye's syndrome prevention but not directly related to reducing the risk of type 2 diabetes.

3. What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?

• A. Teaching how to irrigate the colostomy
• B. Protecting the skin around the colostomy
• C. Discussing the implications of a colostomy during puberty
• D. Using simple, straightforward language to prepare the child

Correct answer: B

Rationale: Protecting the skin around the colostomy is crucial to prevent irritation and infection, which are common complications in infants with colostomies. Teaching and discussing long-term implications are important but secondary to immediate skin care needs.

4. A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and doses of immunizations. What is the most appropriate nursing intervention?

• A. Administer initial immunizations from the beginning of the schedule.
• B. The child cannot receive missed immunizations if the schedule is not followed and will not be vaccinated.
• C. The child should only receive the missed doses of immunizations based on the catch-up schedule.
• D. The child should receive double-strength immunizations at this well visit.

Correct answer: C

Rationale: Children who began primary immunization at the recommended age but fail to receive all the doses do not need to begin the series again but should receive only the missed doses. The child may receive missed vaccinations on a catch-up schedule per CDC guidelines.

5. A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

• A. Propranolol (Inderal)
• B. Calcium gluconate
• C. Mannitol (Osmitrol) or furosemide (Lasix)
• D. Sodium, chloride, and potassium

Correct answer: C

Rationale: Mannitol and furosemide are diuretics commonly used to induce diuresis in acute renal failure, helping to provoke urine flow and manage fluid overload. Calcium gluconate and electrolyte supplementation are used for other specific conditions and not primarily for diuresis.

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