Nursing Elites

1. A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition?

• A. Erythrocyte sedimentation rate
• B. Potassium hydroxide prep
• C. Wound culture
• D. Serum immunoglobulin E (IgE) level

Correct answer: D

Rationale: The correct answer is D: Serum immunoglobulin E (IgE) level. An elevated serum IgE level is commonly associated with atopic dermatitis, reflecting an allergic response. Choice A, erythrocyte sedimentation rate, is a nonspecific test for inflammation and not specific to atopic dermatitis. Choice B, potassium hydroxide prep, is used to diagnose fungal infections like tinea versicolor, not atopic dermatitis. Choice C, wound culture, is not typically indicated for the diagnosis of atopic dermatitis as it is a chronic inflammatory skin condition rather than an infectious process.

2. What is an important nursing responsibility when a dysrhythmia is suspected?

• A. Order an immediate electrocardiogram
• B. Count the radial pulse every minute for five times
• C. Count the apical pulse for 1 full minute and compare the rate with the radial pulse rate
• D. Have someone else take the radial pulse simultaneously with the apical pulse

Correct answer: C

Rationale: When a dysrhythmia is suspected, it is important for nurses to count the apical pulse for a full minute and compare it with the radial pulse rate. This method helps in identifying dysrhythmias because discrepancies between the apical and radial pulse rates can indicate irregular heart rhythms. Option A is incorrect because ordering an immediate electrocardiogram may not always be feasible or necessary as a first step. Option B, counting the radial pulse multiple times, is less accurate than comparing the apical and radial pulse rates. Option D involves an unnecessary step of having another person take simultaneous pulses when the nurse can do it effectively alone.

3. A child with a diagnosis of celiac disease is admitted to the hospital. What dietary restriction should the nurse teach the parents?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by the consumption of gluten, a protein found in wheat, barley, and rye. When individuals with celiac disease ingest gluten, it causes an immune response that attacks the lining of the small intestine. Therefore, avoiding gluten is crucial in managing celiac disease to prevent symptoms and intestinal damage. Choices A, C, and D are incorrect because they do not address the specific dietary restriction necessary for individuals with celiac disease. While some individuals with celiac disease may also have lactose intolerance (not dairy allergy) or may need to manage fat or sugar intake for other health reasons, the primary dietary focus for celiac disease is the strict avoidance of gluten-containing foods.

4. When assessing a 10-month-old infant, what developmental milestone should the nurse expect to observe?

• A. Crawling
• B. Sitting without support
• C. Standing with assistance
• D. Pulling to a stand

Correct answer: D

Rationale: At 10 months of age, pulling to a stand is a developmental milestone that most infants can achieve. Crawling typically occurs around 6-9 months, sitting without support around 6-8 months, and standing with assistance around 7-11 months. Therefore, choices A, B, and C are not the expected developmental milestones for a 10-month-old infant.

5. A 16-year-old is suspected of having type 1 diabetes mellitus. Which clinical manifestation may be present?

• A. moist skin
• B. weight gain
• C. fluid overload
• D. poor wound healing

Correct answer: D

Rationale: Poor wound healing is a common clinical manifestation of type 1 diabetes mellitus. High blood glucose levels in diabetes can impair the body's ability to heal wounds effectively. Choices A, B, and C are incorrect. Moist skin is not a typical clinical manifestation of type 1 diabetes; instead, skin may become dry due to dehydration. Weight gain is unlikely as type 1 diabetes is characterized by weight loss. Fluid overload is also uncommon in type 1 diabetes, which is more commonly associated with dehydration due to frequent urination.

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