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. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

3. What is the required number of milliliters of fluid needed per day for a 14-kg child?

• A. 800
• B. 1000
• C. 1200
• D. 1400

Correct answer: D

Rationale: The fluid requirement for a 14-kg child is approximately 100 mL/kg/day, so for a 14-kg child, the requirement is around 1400 mL/day.

4. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)

• A. Rash
• B. Urticaria
• C. All are applicable
• D. Photosensitivity

Correct answer: C

Rationale: Trimethoprim-sulfamethoxazole (Bactrim) can cause side effects like rash, urticaria, and photosensitivity. Parents and the child should be educated on these potential side effects to ensure prompt recognition and management.

5. While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?

• A. The 6-month-old in deep sleep
• B. The 2-year-old who is cooperative when the nurse takes vital signs
• C. The 4-year-old who is actively watching cartoons
• D. The 14-month-old who is screaming and thrashing his arms and legs

Correct answer: D

Rationale: The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.

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