Nursing Elites

1. A child with ADHD needs help with homework. What should the nurse encourage the parents to do?

• A. Encourage the parents to help the child with homework.
• B. Do the homework for the child.
• C. Set a regular homework schedule.
• D. Provide a quiet environment for homework.

Correct answer: A

Rationale: Encouraging parents to help the child with homework is the most appropriate course of action. By assisting the child, parents can provide necessary support and guidance without taking over the task entirely. This approach fosters independence and helps the child develop academic skills. Option B, doing the homework for the child, is counterproductive as it does not empower the child to learn and grow independently. Option C, setting a regular homework schedule, is important but does not address the immediate need for assistance. Option D, providing a quiet environment for homework, is helpful but does not directly involve parents in supporting the child's academic progress.

2. A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?

• A. Obtain blood culture.
• B. Administer penicillin.
• C. Cover lesion with a dressing.
• D. Prepare her for cesarean section.

Correct answer: D

Rationale: Active herpes lesions at the time of delivery increase the risk of neonatal transmission. The most appropriate action in this scenario is to prepare the client for a cesarean section. A cesarean section is often recommended to reduce the risk of neonatal transmission of herpes simplex virus during delivery, especially when active lesions are present. This intervention helps minimize direct contact between the newborn and the infected genital tract secretions, thereby decreasing the risk of transmission.

3. Assessment findings of a 4-hour-old newborn include: axillary temperature of 96.8°F (35.8°C), heart rate of 150 beats/minute with a soft murmur, irregular respiratory rate at 64 breaths/minute, jitteriness, hypotonia, and weak cry. Based on these findings, which action should the nurse implement?

• A. Swaddle the infant in a warm blanket.
• B. Obtain a heel stick blood glucose level.
• C. Place a pulse oximeter on the heel.
• D. Document the findings in the record.

Correct answer: B

Rationale: The assessment findings in the newborn, such as jitteriness, weak cry, and hypotonia, are indicative of potential hypoglycemia. To confirm this suspicion, the nurse should obtain a heel stick blood glucose level, which is the most appropriate action in this situation. Checking the blood glucose level will provide crucial information to determine the newborn's glucose status and guide further management if hypoglycemia is confirmed. Swaddling the infant in a warm blanket does not address the underlying issue of potential hypoglycemia and may not effectively raise the blood glucose level. Placing a pulse oximeter on the heel is not indicated for assessing hypoglycemia. Documenting the findings in the record is important but does not address the immediate concern of assessing and managing potential hypoglycemia.

4. A client at 28 weeks gestation calls the antepartum clinic and reports experiencing a small amount of bright red vaginal bleeding without uterine contractions or abdominal pain. What instruction should the LPN/LVN provide?

• A. Come to the clinic today for an ultrasound.
• B. Go immediately to the emergency room.
• C. Lie on your left side for about one hour and see if the bleeding stops.
• D. Bring a urine specimen to the lab tomorrow to determine if you have a urinary tract infection.

Correct answer: A

Rationale: Bright red vaginal bleeding without pain could indicate placental issues such as previa. An ultrasound is necessary to evaluate the cause. It is important to rule out potential serious conditions like placental previa, which can lead to further complications for both the mother and the fetus. Therefore, prompt evaluation through an ultrasound at the clinic is essential for appropriate management and ensuring the well-being of the client and her baby.

5. In which chromosome pattern is Duchenne disease inherited?

• A. Autosomal dominant
• B. Autosomal recessive
• C. X-linked recessive
• D. Mitochondrial

Correct answer: C

Rationale: Duchenne disease is caused by a mutation in the DMD gene located on the X chromosome, leading to an X-linked recessive inheritance pattern. Males are typically affected by this disorder as they have only one X chromosome, while females are carriers with one normal and one affected X chromosome.

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