Nursing Elites

1. What should be included in the nursing plan of care for a 6-month-old infant admitted to the pediatric unit with a diagnosis of respiratory syncytial virus (RSV)?

• A. Place the infant in a warm, dry environment.
• B. Allow parents and siblings to visit.
• C. Maintain standard and contact precautions.
• D. Administer prescribed antibiotics immediately.

Correct answer: C

Rationale: The correct answer is C: Maintain standard and contact precautions. RSV is highly contagious, primarily spread through respiratory secretions. Therefore, it is crucial to implement infection control measures such as standard and contact precautions to prevent the spread of the virus to other patients, staff, and visitors. Choice A is incorrect because warmth and dryness are not specific interventions for RSV; the focus should be on infection control. Choice B may increase the risk of exposing others to RSV, so limiting visitors is recommended. Choice D is unnecessary because RSV is a viral infection, and antibiotics are not effective against viruses.

2. A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

• A. We should give this drug after he eats something.
• B. We need to watch carefully for possible infections.
• C. The drug should not be stopped abruptly.
• D. He might experience weight gain with this drug.

Correct answer: A

Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.

3. A nurse is evaluating a 3-year-old child’s developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay?

• A. Copying a square
• B. Hopping on one foot
• C. Catching a ball reliably
• D. Using a spoon effectively

Correct answer: A

Rationale: The correct answer is A: Copying a square. At 3 years old, children should be able to copy a square as part of their fine motor skill development. The inability to perform this task may indicate a developmental delay in fine motor skills. Choice B, hopping on one foot, typically develops around 4-5 years of age, so it is not a reliable indicator of a delay at 3. Choice C, catching a ball reliably, involves coordination skills that develop later in childhood, making it less relevant for a 3-year-old assessment. Choice D, using a spoon effectively, is more related to self-care and feeding skills rather than fine motor development, so it is not the best indicator of a developmental delay in this context.

4. A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is essential for managing type 1 diabetes mellitus. Hypoglycemia, which occurs when blood glucose levels drop too low, can be dangerous and requires immediate intervention to prevent severe complications. Monitoring blood glucose levels more frequently than once a day, following a strict meal plan, and administering insulin only when blood glucose is high are important aspects of diabetes management but recognizing signs of hypoglycemia is crucial as it enables prompt action to prevent adverse outcomes.

5. When administering IV fluids to a dehydrated infant, what intervention is most important at this time?

• A. Continuing the prescribed flow rate
• B. Monitoring the intravenous drop rate
• C. Calculating the total necessary intake
• D. Maintaining the fluid at body temperature

Correct answer: B

Rationale: Monitoring the intravenous drop rate is crucial when administering IV fluids to ensure that the correct amount of fluids is delivered to the dehydrated infant. Choice A assumes the initial rate is correct without ongoing assessment. Choice C, while important, does not address the immediate need for monitoring the infusion rate. Choice D, maintaining the fluid at body temperature, is essential for comfort but is not as critical as ensuring the correct fluid delivery rate. By monitoring the intravenous drop rate, healthcare providers can adjust the flow as needed to prevent overhydration or underhydration, helping to manage the infant's fluid balance effectively.

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