Nursing Elites

1. When planning care for a child diagnosed with rheumatic fever, what is the primary goal of nursing care?

• A. Reduce fever.
• B. Maintain fluid and electrolyte balance.
• C. Prevent cardiac damage.
• D. Maintain joint mobility and function.

Correct answer: C

Rationale: The primary goal of nursing care for a child diagnosed with rheumatic fever is to prevent cardiac damage. Rheumatic fever can lead to complications affecting the heart, making it crucial to monitor and prevent cardiac involvement to avoid long-term consequences. While addressing fever and joint pain are important aspects of care, preventing cardiac damage takes precedence in managing rheumatic fever. Therefore, choices A, B, and D are not the primary goals of nursing care in this case.

2. The caregiver is caring for a 2-month-old infant with a diagnosis of bronchiolitis. Which assessment finding would be most concerning to the caregiver?

• A. Nasal flaring and grunting
• B. Coughing and wheezing
• C. Poor feeding and irritability
• D. Increased respiratory rate

Correct answer: A

Rationale: Nasal flaring and grunting are indicative of respiratory distress, suggesting the infant is having difficulty breathing. This finding requires immediate attention as it signifies a more severe respiratory compromise compared to the other symptoms listed.

3. A child with sickle cell anemia is being treated for a vaso-occlusive crisis. Which intervention should the practical nurse (PN) implement?

• A. Apply cold packs to painful areas.
• B. Encourage increased fluid intake.
• C. Administer high doses of vitamin C.
• D. Provide low-calorie meals.

Correct answer: B

Rationale: Encouraging increased fluid intake is crucial in managing vaso-occlusive crises in patients with sickle cell anemia. Dehydration can worsen these crises, so adequate hydration is essential to prevent complications and improve outcomes. Applying cold packs to painful areas may exacerbate vaso-occlusive crises by causing vasoconstriction. Administering high doses of vitamin C is not directly indicated for vaso-occlusive crises in sickle cell anemia. Providing low-calorie meals is not the priority during a vaso-occlusive crisis; maintaining adequate nutrition is important, but hydration takes precedence in this situation.

4. A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?

• A. Increased weight gain
• B. Decreased heart rate
• C. Reduced headaches
• D. Diminished fatigue

Correct answer: B

Rationale: The correct answer is B: 'Decreased heart rate.' Propranolol is a beta-blocker commonly used to manage symptoms of hyperthyroidism, including tachycardia. Monitoring for a decreased heart rate is important as it indicates the drug's therapeutic response in controlling the elevated heart rate associated with Graves' disease. Choices A, C, and D are incorrect because weight gain, reduced headaches, and diminished fatigue are not typical therapeutic responses to propranolol in the context of managing Graves' disease.

5. A child with cystic fibrosis is admitted to the hospital with respiratory distress. Which intervention should the practical nurse (PN) implement?

• A. Administer bronchodilators as prescribed.
• B. Limit fluid intake.
• C. Provide a high-fat diet.
• D. Encourage bed rest only.

Correct answer: A

Rationale: Administering bronchodilators as prescribed is crucial for managing respiratory distress in children with cystic fibrosis. Bronchodilators help to open the airways, facilitating easier breathing for the child. Limiting fluid intake, providing a high-fat diet, or encouraging bed rest only are not appropriate interventions for respiratory distress associated with cystic fibrosis. Limiting fluid intake could worsen dehydration, a high-fat diet is not recommended due to pancreatic insufficiency in cystic fibrosis, and bed rest alone does not address the respiratory distress.

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