Nursing Elites

1. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?

• A. Monitor for signs of infection
• B. Monitor blood pressure
• C. Monitor for hyperglycemia
• D. Monitor for hypertension

Correct answer: A

Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention. While monitoring blood pressure, hyperglycemia, and hypertension are important considerations in certain conditions and treatments, they are not the primary concern when a child with nephrotic syndrome is on corticosteroid therapy.

2. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?

• A. Instructing the parents to report adverse reactions to the growth hormone treatment
• B. Teaching the parents how to administer desmopressin acetate
• C. Informing the parents that treatment stops when puberty begins
• D. Educating the parents to report signs of acute adrenal crisis

Correct answer: B

Rationale: In a child with a disorder of the posterior pituitary gland, desmopressin acetate is commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents to administer desmopressin acetate correctly is essential for the child's treatment. The other options are incorrect because growth hormone treatment, stopping treatment at puberty, and reporting signs of acute adrenal crisis are not directly related to managing a disorder of the posterior pituitary gland.

3. A child is admitted to the hospital with pneumonia. What is the priority need that must be included in the nursing plan of care for this child?

• A. Rest
• B. Exercise
• C. Nutrition
• D. Elimination

Correct answer: A

Rationale: The correct answer is Rest. When a child is admitted to the hospital with pneumonia, the priority need in the nursing plan of care is to ensure adequate rest for the child. Rest is crucial as it allows the child's body to fight the infection and recover. Choice B, Exercise, is incorrect as strenuous physical activity may further strain the child's respiratory system. Choice C, Nutrition, is important but providing rest takes precedence initially. Choice D, Elimination, is not the priority concern in this scenario compared to ensuring rest for recovery from pneumonia.

4. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department, and her arm placed in a cast. At 11 p.m., her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?

• A. Notifying the doctor immediately
• B. Applying ice
• C. Elevating the arm
• D. Giving additional pain medication as ordered

Correct answer: A

Rationale: The correct action would be to notify the doctor immediately. Unrelenting pain despite medication can indicate compartment syndrome, which is a medical emergency requiring immediate attention. Applying ice or elevating the arm may not address the potential serious underlying issue of compartment syndrome. Giving additional pain medication without further assessment could delay necessary intervention and potentially worsen the condition.

5. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include

• A. Oxygen, uterine massage, and transport
• B. Oxygen, placement on the left side, and transport
• C. Oxygen, treatment for shock, and uterine massage during transport
• D. Oxygen, internal vaginal pads, and treatment for shock during transport

Correct answer: C

Rationale: In this scenario, the 21-year-old mother is showing signs of hemorrhagic shock with increased heart rate, diaphoresis, and vaginal bleeding. The appropriate management includes providing oxygen to support tissue perfusion, treating for shock to restore adequate circulation, and performing uterine massage to help control bleeding during transport. Options A, B, and D do not address the comprehensive management needed for postpartum hemorrhage in this situation.

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