Nursing Elites

1. A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

• A. We should give this drug after he eats something.
• B. We need to watch carefully for possible infections.
• C. The drug should not be stopped abruptly.
• D. He might experience weight gain with this drug.

Correct answer: A

Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.

2. The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule
• B. Macule
• C. Vesicle
• D. Scale

Correct answer: B

Rationale: A macule is defined as a flat, discolored area on the skin that is different from surrounding tissue due to a change in color. In this case, the baby has a flat, discolored area on the skin, which fits the description of a macule. A papule is a small, raised solid bump, a vesicle is a small fluid-filled blister, and a scale is a flake of skin that is often dry and rough. Therefore, choices A, C, and D do not accurately describe the flat, discolored area on the baby's skin, making them incorrect.

3. When caring for a 2-year-old girl who is wheezing and has difficulty breathing, which interview question would provide the most useful information related to the symptoms of the child?

• A. Inquiring about child safety in the home
• B. Asking about the temperament of the child
• C. Asking about the child's diet
• D. Asking the parents if they smoke in the home

Correct answer: D

Rationale: Asking the parents if they smoke in the home is the most relevant question as exposure to secondhand smoke can exacerbate respiratory symptoms like wheezing and difficulty breathing in children. This information is crucial for identifying potential triggers for the child's symptoms. Inquiring about child safety in the home, asking about the child's temperament, and inquiring about the child's diet, while important aspects of care, may not directly address the respiratory symptoms the child is experiencing.

4. After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?

• A. Thickened formula 24 hours after surgery
• B. Withholding feedings for the first 24 hours
• C. Regular formula feeding within 24 hours after surgery
• D. Additional glucose feedings as desired after the first 24 hours

Correct answer: C

Rationale: Following surgery for hypertrophic pyloric stenosis (HPS) in infants, it is appropriate to resume regular formula feeding within 24 hours postoperatively to support recovery. This helps maintain adequate nutrition and hydration for the infant. Choice A is incorrect because thickened formula may not be necessary and could potentially cause issues postoperatively. Choice B is incorrect as withholding feedings for the first 24 hours can lead to nutritional deficiencies and delay recovery. Choice D is inappropriate as additional glucose feedings are not typically indicated postoperatively for infants with HPS and may not provide the necessary nutrition needed for recovery.

5. When administering IV fluids to a dehydrated infant, what intervention is most important at this time?

• A. Continuing the prescribed flow rate
• B. Monitoring the intravenous drop rate
• C. Calculating the total necessary intake
• D. Maintaining the fluid at body temperature

Correct answer: B

Rationale: Monitoring the intravenous drop rate is crucial when administering IV fluids to ensure that the correct amount of fluids is delivered to the dehydrated infant. Choice A assumes the initial rate is correct without ongoing assessment. Choice C, while important, does not address the immediate need for monitoring the infusion rate. Choice D, maintaining the fluid at body temperature, is essential for comfort but is not as critical as ensuring the correct fluid delivery rate. By monitoring the intravenous drop rate, healthcare providers can adjust the flow as needed to prevent overhydration or underhydration, helping to manage the infant's fluid balance effectively.

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