Nursing Elites

1. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• 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 gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

2. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.

3. What should the nurse suggest to a parent asking for advice on managing their child's earache and fever?

• A. Applying a warm compress to the affected ear
• B. Giving the child a cold drink
• C. Administering acetaminophen
• D. Taking the child to the emergency department

Correct answer: A

Rationale: The correct answer is to suggest applying a warm compress to the affected ear. This can help alleviate pain and discomfort associated with the earache. Giving a cold drink (Choice B) may not address the underlying issue and is not a recommended treatment for earaches. Administering acetaminophen (Choice C) can help reduce fever but may not directly target the earache. Taking the child to the emergency department (Choice D) is usually not necessary for a common earache unless there are severe symptoms or complications present.

4. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

5. An order is written for an isotonic enema for a 2-year-old child. What is the maximum amount of fluid the nurse should administer without a specific order from the health care provider?

• A. 100 to 150 mL
• B. 155 to 250 mL
• C. 255 to 360 mL
• D. 365 to 500 mL

Correct answer: B

Rationale: For a 2-year-old child, the maximum recommended amount of fluid for an isotonic enema is between 155 to 250 mL to prevent overdistension and potential harm. Choice A (100 to 150 mL) is too low and may not be effective in achieving the desired outcome. Choices C (255 to 360 mL) and D (365 to 500 mL) exceed the safe range for a 2-year-old child and can lead to overdistension, electrolyte imbalance, or other complications. Therefore, the correct answer is B.

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