Nursing Elites

1. After a cardiac catheterization, what is the priority nursing care for a 3-year-old child?

• A. Encouraging early ambulation
• B. Monitoring the site for bleeding
• C. Restricting fluids until the blood pressure is stabilized
• D. Comparing the blood pressure of both lower extremities

Correct answer: B

Rationale: After a cardiac catheterization, the priority nursing care for a 3-year-old child is monitoring the site for bleeding. This is essential to promptly identify and address any signs of bleeding or hematoma formation, which are potential complications of the procedure. Encouraging early ambulation may be beneficial post-procedure but ensuring site integrity takes precedence. Restricting fluids until blood pressure stabilization is not a standard post-catheterization practice, as adequate hydration is crucial for recovery. Comparing the blood pressure of both lower extremities is not a priority immediate nursing action after a cardiac catheterization in a pediatric patient.

2. A nurse is providing care to a child with a diagnosis of bronchiolitis. What is the priority nursing intervention?

• A. Administering bronchodilators
• B. Providing respiratory therapy
• C. Monitoring oxygen saturation
• D. Encouraging fluid intake

Correct answer: B

Rationale: The correct answer is providing respiratory therapy. In bronchiolitis, the priority is to maintain airway patency through interventions such as suctioning, positioning, and oxygen therapy. While bronchodilators may be used in some cases, they are not the initial priority. Monitoring oxygen saturation is important but comes after ensuring airway patency. Encouraging fluid intake is essential for hydration but is not the priority over maintaining a patent airway.

3. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: Avoiding gluten is not typically necessary for managing gastroesophageal reflux disease (GERD) in children. The correct dietary instruction for a 2-year-old with GERD would be to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux symptoms. While spicy foods and dairy products may also trigger reflux in some individuals, the primary focus should be on avoiding high-fat foods due to their direct impact on the lower esophageal sphincter, which exacerbates GERD symptoms.

4. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.

5. What finding would lead healthcare providers to suspect Turner syndrome in a child?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.

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