Nursing Elites

1. For a 6-year-old child with hypokalemia, which menu choice should the nurse encourage?

• A. Pizza with a fruit plate
• B. Chicken strips with chips
• C. Fajita with rice
• D. Hamburger with French fries

Correct answer: A

Rationale: Pizza with a fruit plate is the most suitable choice for a 6-year-old child with hypokalemia due to its potassium content. Potassium-rich foods like fruits can help replenish potassium levels in the body, aiding in the treatment of hypokalemia.

2. The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'? What is the nurse's best response?

• A. They are going to fix you up 'down there'.
• B. They will move your testicle from your abdomen to your scrotum.
• C. What do you think your doctor is going to do?
• D. You shouldn't worry. Your doctor knows exactly what to do.

Correct answer: C

Rationale: The nurse should encourage the child to express his thoughts and feelings about the upcoming surgery. This approach helps the child feel heard and understood while providing an opportunity to address any misconceptions or fears. By asking the child what he thinks the doctor will do, the nurse engages the child in a conversation that can help alleviate anxiety and build trust. School-age children often have fears related to bodily harm, and open communication can help alleviate such concerns. Choices A and D do not encourage open communication or address the child's concerns directly. Choice B provides too much detail that may overwhelm the child and is not age-appropriate for a 6-year-old.

3. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

4. The patient taking spironolactone (Aldactone) makes a statement indicating effective teaching. Which statement shows understanding of the teaching?

• A. I will use salt substitutes to lower my sodium intake
• B. I will increase my intake of foods that are high in potassium
• C. I will call my doctor if I begin having menstrual irregularities
• D. I will take this medication at bedtime each evening

Correct answer: C

Rationale: The correct answer is C because spironolactone is a potassium-sparing diuretic that can cause endocrine effects like menstrual irregularities. Therefore, the patient recognizing the need to report such changes indicates effective teaching. Choices A and B are incorrect as salt substitutes and high-potassium foods should be avoided with spironolactone. Choice D is also incorrect because diuretics, including spironolactone, are ideally taken in the morning to prevent disturbances in sleep due to nocturia.

5. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?

• A. Draw a stick figure with seven body parts
• B. Draw a circle
• C. Identify right from left hand
• D. Tie their shoelaces

Correct answer: B

Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.

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