Nursing Elites

1. A 7-year-old child is admitted to the hospital with nephrotic syndrome. The nurse notes that the child has gained 3 pounds in the past 24 hours. What should the nurse do first?

• A. Administer a diuretic as prescribed
• B. Restrict the child’s fluid intake
• C. Notify the healthcare provider
• D. Measure the child’s abdominal girth

Correct answer: C

Rationale: In a child with nephrotic syndrome experiencing sudden weight gain, the priority action for the nurse is to notify the healthcare provider. This weight gain could indicate worsening edema or fluid retention, necessitating immediate medical evaluation and intervention. The healthcare provider can conduct a comprehensive assessment, order necessary tests, and adjust the treatment plan accordingly. Administering a diuretic, restricting fluid intake, or measuring abdominal girth should not be initiated without healthcare provider consultation to ensure appropriate management of the child's condition.

2. A 7-year-old child with leukemia is receiving chemotherapy. The mother asks the practical nurse (PN) how to manage the child's nausea at home. What advice should the PN provide?

• A. Provide small, frequent meals.
• B. Encourage the child to eat spicy foods.
• C. Offer large meals less frequently.
• D. Allow the child to eat whatever they want.

Correct answer: A

Rationale: During chemotherapy, children may experience nausea. Providing small, frequent meals can help manage nausea as they are easier to tolerate, reducing the likelihood of vomiting. It is important to offer bland, non-spicy foods to avoid exacerbating nausea. Encouraging large meals less frequently or allowing the child to eat whatever they want may overwhelm the digestive system and worsen nausea. Therefore, the correct advice is to provide small, frequent meals to help the child manage nausea effectively.

3. What suggestion should the nurse provide to prevent diaper rash in a 4-month-old infant as requested by the mother?

• A. Generously powder the baby's diaper area with talcum powder at each diaper change to promote dryness.
• B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.
• C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.
• D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.

Correct answer: C

Rationale: Using a barrier cream like zinc oxide forms a protective layer on the skin, creating a barrier against irritants and moisture, thus helping to prevent diaper rash. Unlike other options, barrier creams do not need to be completely removed at each diaper change, allowing the skin to remain protected between changes.

4. The practical nurse is caring for a child who was admitted for treatment of seizures. Which intervention should the nurse implement to help prevent injury from a seizure?

• A. Have a padded tongue depressor at the bedside.
• B. Keep the side rails padded and in an upright position.
• C. Place a padded helmet on the child’s head.
• D. Restrain the child during the seizure activity.

Correct answer: B

Rationale: The correct intervention to help prevent injury during a seizure is to keep the side rails padded and in an upright position. This measure helps to ensure the child's safety by preventing falls or accidental injuries. Using a padded tongue depressor or restraining the child can potentially cause harm and are not recommended. Placing a padded helmet is not a standard intervention for seizure safety in this scenario.

5. The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?

• A. Alternate glucose water with formula
• B. Mix the formula with rice cereal
• C. Add multivitamins with iron to the formula
• D. Use water to dilute the formula

Correct answer: B

Rationale: The correct instruction for promoting adequate nutrition in a 6-month-old infant with GERD is to mix the formula with rice cereal. This thickens the feed, reducing the risk of reflux, aiding in proper nutrition, and minimizing GERD symptoms. Choices A, C, and D are incorrect. Alternating glucose water with formula, adding multivitamins with iron to the formula, or diluting the formula with water are not recommended measures for promoting adequate nutrition in infants with GERD.

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