Nursing Elites

1. A child with a diagnosis of cystic fibrosis is admitted to the hospital. What is the priority nursing intervention?

• A. Administering pancreatic enzymes
• B. Providing respiratory therapy
• C. Providing nutritional support
• D. Encouraging physical activity

Correct answer: A

Rationale: The correct answer is administering pancreatic enzymes. In cystic fibrosis, the pancreas is often affected, leading to insufficient production of digestive enzymes. Administering pancreatic enzymes is crucial to ensure proper digestion and absorption of nutrients. While respiratory therapy, nutritional support, and physical activity are essential components of care for individuals with cystic fibrosis, addressing the digestive aspect by administering pancreatic enzymes takes priority to prevent malnutrition and promote overall health.

2. A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?

• A. Administering IV immunoglobulin
• B. Monitoring for coronary artery aneurysms
• C. Encouraging fluid intake
• D. Providing nutritional support

Correct answer: B

Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to the development of coronary artery aneurysms, which are one of the most serious complications of the disease. Early detection and monitoring of coronary artery changes are essential for prompt intervention and prevention of adverse outcomes. Administering IV immunoglobulin is an important treatment for Kawasaki disease, but monitoring for coronary artery aneurysms takes precedence as it directly impacts the child's long-term prognosis. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for potential life-threatening complications.

3. An infant is diagnosed with Hirschsprung disease. What nursing intervention is essential before surgery?

• A. Administering antibiotics
• B. Ensuring bowel rest
• C. Performing regular enemas
• D. Maintaining NPO status

Correct answer: D

Rationale: Maintaining NPO (nothing by mouth) status is essential before surgery for a patient with Hirschsprung disease to prevent aspiration. Administering antibiotics, ensuring bowel rest, and performing regular enemas are not the priority interventions before surgery for this condition. Administering antibiotics may be necessary in the postoperative period to prevent infection, ensuring bowel rest can be beneficial but is not the priority, and performing regular enemas is not typically recommended before surgery for Hirschsprung disease.

4. .A nurse is performing a physical examination on an infant with Down syndrome. For what anomaly should the nurse assess the child?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Abnormal heart sounds could indicate a congenital heart defect, which is common in infants with Down syndrome.

5. A 3-year-old child is being discharged after being treated for dehydration. What should the nurse include in the discharge teaching?

• A. Monitor for signs of infection
• B. Monitor for signs of dehydration
• C. Monitor for signs of hypovolemia
• D. Monitor for signs of malnutrition

Correct answer: B

Rationale: Correct! When a child is being discharged after treatment for dehydration, it is important to educate caregivers about monitoring for signs of dehydration to prevent reoccurrence. Dehydration is the primary concern in this scenario, as the child's fluid levels need to be closely monitored. Choices A, C, and D are incorrect because while infection, hypovolemia, and malnutrition are also important considerations in pediatric care, the immediate focus after treating dehydration should be on preventing its recurrence by monitoring for signs of dehydration.

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