Nursing Elites

1. After a 7-year-old with acute diarrhea has been rehydrated with oral rehydration solutions, what type of diet should the nurse recommend following rehydration?

• A. Regular diet
• B. Fruit juices
• C. High carbohydrate diet
• D. BRAT diet (bananas, rice, apples, and toast or tea)

Correct answer: A

Rationale: After rehydration, a regular diet is generally recommended to ensure proper nutrition and recovery. A regular diet includes a balanced intake of all food groups and nutrients. Fruit juices may be too high in simple sugars and lack necessary nutrients, which can exacerbate diarrhea. While a high carbohydrate diet may be beneficial in some cases, a regular diet is more comprehensive. The BRAT diet, consisting of bananas, rice, apples, and toast or tea, was previously recommended for diarrhea, but it lacks adequate protein and fat, so a regular diet is now preferred for overall better nutrition and recovery.

2. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?

• A. Indicative of maladjustment
• B. A common reaction to divorce
• C. Suggestive of a lack of adequate parenting
• D. An unusual response that indicates a need for referral

Correct answer: B

Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.

3. What is a common sign of moderate dehydration in children?

• A. Dry mucous membranes
• B. Normal capillary refill
• C. Hyperactive bowel sounds
• D. Edema

Correct answer: A

Rationale: Dry mucous membranes are a common sign of moderate dehydration in children, indicating a loss of bodily fluids. When a child is moderately dehydrated, the mucous membranes in the mouth and nose may appear dry. This condition can occur due to various factors such as vomiting, diarrhea, or inadequate fluid intake. Normal capillary refill (choice B) is not typically associated with dehydration; it is a measure of circulatory status. Hyperactive bowel sounds (choice C) can be present in conditions like gastroenteritis but are not specific to dehydration. Edema (choice D) is the retention of fluid in the body and is not a typical sign of dehydration.

4. The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. What is the nurse's best response?

• A. Allow him to cry for no longer than 15 minutes and then pick him up
• B. Babies need comforting and cuddling. Meeting these needs will not spoil him
• C. Babies this young cry when they are hungry. Try feeding him when he cries
• D. If he isn’t soiled or wet, leave him, and he'll cry himself to sleep

Correct answer: B

Rationale: Comforting and cuddling a 2-month-old baby when they cry helps build trust and security. At this age, responding to cries does not lead to spoiling, but rather supports healthy emotional development.

5. A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

• A. Prominent abdomen
• B. Forward curve of the spine in the sacral area
• C. Increase in height of 5 inches in the past year
• D. Total weight gain of 15 lb in the past year

Correct answer: D

Rationale: The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.

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