Nursing Elites

1. A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital. Which information is most important for the nurse to provide the parents prior to discharge?

• A. Nutritional guidelines to support blood health
• B. Signs of infection to monitor for
• C. When to give pain medication
• D. Instructions about how much fluid the child should drink daily

Correct answer: D

Rationale: Proper hydration is crucial in managing sickle cell anemia (SCA) as it helps prevent sickling of red blood cells and reduces blood viscosity, which can lead to painful crises. Ensuring the child drinks enough fluids is essential to maintain adequate hydration levels and reduce the risk of complications. While nutritional guidelines and recognizing signs of infection are important aspects of care, maintaining proper hydration is the most immediate and critical factor in managing SCA and preventing crises.

2. A client on mechanical ventilation is experiencing high-pressure alarms. What action should the nurse implement first?

• A. Check the client's oxygen saturation.
• B. Assess the client's endotracheal tube for obstruction.
• C. Reposition the client to relieve pressure.
• D. Suction the client's airway.

Correct answer: B

Rationale: The correct answer is to assess the client's endotracheal tube for obstruction. When a client on mechanical ventilation experiences high-pressure alarms, the first action should be to check for any potential obstructions in the airway, which can trigger the alarms. Checking the oxygen saturation (Choice A) is important but not the priority when dealing with high-pressure alarms. Repositioning the client (Choice C) may be necessary later but should not be the initial action. Suctioning the client's airway (Choice D) should only be done after assessing for and addressing any obstructions in the endotracheal tube.

3. A client with chronic kidney disease is prescribed a low-potassium diet. Which food should the nurse instruct the client to avoid?

• A. Carrots
• B. White bread
• C. Bananas
• D. Apples

Correct answer: C

Rationale: The correct answer is C: Bananas. Bananas are high in potassium and should be avoided in clients who are on a low-potassium diet due to chronic kidney disease. Foods like apples and white bread are low in potassium and are safer choices. Carrots are also low in potassium and do not need to be avoided in this case.

4. A client with pneumonia is receiving oxygen via nasal cannula at 2 L/min. What assessment finding indicates the need for further intervention?

• A. The client reports feeling short of breath.
• B. The client's oxygen saturation is 92%.
• C. The client's respiratory rate is 20 breaths per minute.
• D. The client is unable to complete sentences without pausing.

Correct answer: D

Rationale: The correct answer is D because the inability to complete sentences without pausing indicates respiratory distress and the need for immediate intervention. This finding suggests an increased work of breathing and inadequate oxygenation. Choices A, B, and C are not as urgent as choice D. Feeling short of breath (choice A) is expected in pneumonia but does not necessarily indicate the need for immediate intervention. An oxygen saturation of 92% (choice B) is slightly below the normal range but may not require immediate intervention. A respiratory rate of 20 breaths per minute (choice C) is within the normal range and does not signify an urgent need for intervention.

5. Which of the following statements reflects appropriate teaching to prevent injury in a client with rheumatoid arthritis?

• A. Use heat applications to relieve swelling and stiffness.
• B. Take warm showers before activity.
• C. Use cold packs to relieve joint pain.
• D. Take prescribed anti-inflammatory medications with meals.

Correct answer: C

Rationale: The correct answer is C. Using cold packs to relieve joint pain is appropriate for clients with rheumatoid arthritis as cold therapy is more effective at reducing inflammation and pain in these conditions. Heat applications may exacerbate the symptoms by increasing swelling. Taking warm showers before activity may provide comfort but does not directly address joint pain or prevent injury. While anti-inflammatory medications are commonly prescribed, they are not directly related to preventing injury in clients with rheumatoid arthritis.

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