Nursing Elites

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

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.

2. A child with a diagnosis of congenital heart disease is admitted to the hospital. What should the nurse include in the child’s care plan?

• A. Monitoring fluid status
• B. Encouraging activity
• C. Promoting a high-calorie diet
• D. Maintaining oxygen therapy

Correct answer: A

Rationale: Monitoring fluid status is crucial for a child with congenital heart disease because these children are at risk of fluid overload, which can exacerbate their condition. Monitoring fluid intake and output helps prevent complications such as heart failure. Encouraging activity may be important, but it should be done cautiously and within limits due to the child's cardiac condition. Promoting a high-calorie diet is not typically a priority in congenital heart disease care unless there are specific indications. Maintaining oxygen therapy may be necessary in some cases but is not the primary intervention for managing congenital heart disease.

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: The correct nursing intervention essential before surgery for an infant with Hirschsprung disease is maintaining NPO (nothing by mouth) status. This is important to prevent aspiration during and after the surgical procedure. Administering antibiotics (Choice A) may be necessary in some cases but is not the priority intervention before surgery. Ensuring bowel rest (Choice B) is not directly related to preparing for surgery and may not be the most critical intervention. Performing regular enemas (Choice C) is not recommended before surgery for Hirschsprung disease as it can aggravate the condition.

4. What is an early sign of congestive heart failure that the nurse should recognize?

• A. Tachypnea
• B. Bradycardia
• C. Inability to sweat
• D. Increased urinary output

Correct answer: A

Rationale: Tachypnea, which refers to rapid breathing, is an early sign of congestive heart failure. In heart failure, the heart's inability to pump efficiently can lead to fluid accumulation in the lungs, causing the child to breathe faster to try to compensate for the decreased oxygen exchange. Bradycardia (slow heart rate) is not typically associated with congestive heart failure; instead, it may indicate a different issue. Inability to sweat is not a common early sign of congestive heart failure. Increased urinary output is not a typical early sign of congestive heart failure; instead, it may be a sign of other conditions like diabetes or kidney issues.

5. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?

• A. I need to avoid pushing or pulling on an arm or leg.
• B. I must avoid lifting the baby from under the armpits.
• C. I should not bend an arm or leg into an awkward position.
• D. We must avoid lifting the legs by the ankles to change diapers.

Correct answer: B

Rationale: Lifting the baby from under the armpits can cause fractures in infants with osteogenesis imperfecta. The correct approach is to support the baby's body and head carefully, avoiding pressure on vulnerable areas prone to fractures. Choices A, C, and D demonstrate proper awareness of caring for an infant with osteogenesis imperfecta by emphasizing caution to prevent fractures.

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