Nursing Elites

1. A 3-year-old child is being discharged after being treated for dehydration. What should be included in the discharge teaching?

• A. Monitor for signs of infection
• B. Monitor for signs of dehydration
• C. Monitor for signs of hypovolemia
• D. Monitor for signs of malnutrition

Correct answer: B

Rationale: The correct answer is to monitor for signs of dehydration. After treatment for dehydration, it is crucial to educate caregivers about recognizing early signs of dehydration to prevent its recurrence. Monitoring for dehydration ensures that appropriate measures can be taken promptly if signs reappear. Choices A, C, and D are incorrect because infection, hypovolemia, and malnutrition, while important considerations in healthcare, are not the primary focus after treating dehydration in a 3-year-old child.

2. A healthcare professional is teaching a class of new parents about how to position their infants during the first few weeks of life. Which position is safest?

• A. On the back, lying flat
• B. On either side, lying flat
• C. Head slightly elevated on the left side
• D. Head slightly elevated on the right side

Correct answer: A

Rationale: The correct answer is 'On the back, lying flat.' Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position promotes safe sleep practices and helps prevent accidental suffocation. Choices B, C, and D are incorrect as placing infants on their side or with the head slightly elevated may increase the risk of breathing difficulties or other hazards during sleep.

3. At 7 AM, a nurse receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?

• A. Encourage the adolescent to start exercising.
• B. Ask the adolescent to obtain an immediate glucometer reading.
• C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
• D. Tell the adolescent that the prescribed dose of rapid acting insulin should be administered.

Correct answer: D

Rationale: Rapid acting insulin will help lower the elevated blood glucose level quickly.

4. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

• A. metabolic alkalosis due to insufficient production of acid metabolites
• B. respiratory alkalosis due to depressed respirations and retention of carbon dioxide
• C. respiratory acidosis due to impaired respirations and increased formation of carbonic acid
• D. metabolic acidosis due to the kidneys' inability to compensate for decreased carbonic acid formation

Correct answer: C

Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis. This occurs due to impaired respirations, leading to the retention of carbon dioxide and the formation of carbonic acid. Choice A is incorrect as metabolic alkalosis is not expected in this situation. Choice B is incorrect as respiratory alkalosis does not align with the scenario of impaired respirations in severe asthma attacks. Choice D is also incorrect as it describes metabolic acidosis, which is not typically associated with severe asthma attacks.

5. Why does a cleft lip predispose an infant to infection?

• A. Waste products accumulate along the defect.
• B. There is evidence of inadequate circulation in the defective area.
• C. Nutrition is inadequate due to ineffective feeding.
• D. Mouth breathing dries the oropharyngeal mucous membranes.

Correct answer: D

Rationale: The correct answer is D. Mouth breathing due to a cleft lip can dry the mucous membranes, making them more susceptible to infection. Choice A is incorrect because waste products do not accumulate along the defect to predispose the infant to infection. Choice B is incorrect as there is no evidence of inadequate circulation being a primary factor in infection predisposition in cleft lip cases. Choice C is incorrect because although ineffective feeding may lead to other issues, it is not the main reason for infection predisposition in infants with a cleft lip.

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