Nursing Elites

1. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?

• A. Syndrome of inappropriate antidiuretic hormone (SIADH)
• B. Thyroid storm
• C. Cushing syndrome
• D. Vitamin D toxicity

Correct answer: A

Rationale: When a child with diabetes insipidus is treated with vasopressin, the nurse should closely monitor for signs and symptoms of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Vasopressin, also known as antidiuretic hormone, helps retain water in the body. Excessive vasopressin administration can lead to water retention, dilutional hyponatremia, and potentially result in SIADH. Choices B, C, and D are incorrect because they are not directly associated with the use of vasopressin in treating diabetes insipidus.

2. A child with a diagnosis of sickle cell anemia is admitted to the hospital with a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, the priority nursing intervention is administering pain medication. Pain management is crucial to alleviate the intense pain experienced by the child. While administering oxygen can help improve oxygenation, it is not the most critical intervention during a vaso-occlusive crisis. Monitoring fluid intake is important for overall care but is not the immediate priority during a crisis. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can worsen the pain and the crisis itself.

3. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential in managing type 1 diabetes mellitus as it helps in monitoring blood sugar levels at different times of the day and adjusting insulin doses accordingly. Option B about using a lancet device to obtain blood samples is a technique rather than an emphasis on monitoring frequency. Option C suggesting the use of urine test strips is incorrect as urine test strips are not recommended for accurate real-time monitoring of blood glucose levels in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when educating about blood glucose monitoring.

4. Which best describes a full-thickness (third-degree) burn?

• A. Erythema and pain
• B. Skin showing erythema followed by blister formation
• C. Destruction of all layers of skin evident with extension into subcutaneous tissue
• D. Destruction injury involving underlying structures such as muscle, fascia, and bone

Correct answer: C

Rationale: A full-thickness (third-degree) burn involves the destruction of all layers of skin, including the epidermis, dermis, and extending into the subcutaneous tissue. This type of burn results in significant tissue damage and can appear pale, charred, or leathery. Choice A is incorrect as erythema and pain are more characteristic of superficial burns. Choice B describes a partial-thickness burn where the skin shows erythema followed by blister formation, involving the epidermis and part of the dermis. Choice D is incorrect as it describes a deeper type of injury involving structures beyond the skin layers, such as muscle, fascia, and bone, which is not specific to a full-thickness burn.

5. A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) is made and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care?

• A. Place the infant in a warm, dry environment.
• B. Allow parents and siblings to visit.
• C. Maintain standard and contact precautions.
• D. Administer prescribed antibiotics immediately.

Correct answer: C

Rationale: The correct answer is to maintain standard and contact precautions. RSV is highly contagious, primarily spreading through respiratory secretions. Therefore, it is crucial to implement infection control measures to prevent the spread of the virus within the healthcare setting. Option A is incorrect as warmth and dryness are not the primary concern in RSV management. While family support is important, allowing visits may increase the risk of spreading the infection, making option B less appropriate. Option D is incorrect because RSV is a viral infection, and antibiotics are not effective against viruses.

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