Nursing Elites

1. A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is essential for managing type 1 diabetes mellitus. Hypoglycemia, which occurs when blood glucose levels drop too low, can be dangerous and requires immediate intervention to prevent severe complications. Monitoring blood glucose levels more frequently than once a day, following a strict meal plan, and administering insulin only when blood glucose is high are important aspects of diabetes management but recognizing signs of hypoglycemia is crucial as it enables prompt action to prevent adverse outcomes.

2. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?

• A. Duvall's developmental theory
• B. Friedman's structural functional theory
• C. Von Bertalanffy's general system theory applied to families
• D. Resiliency model of family stress, adjustment, and adaptation

Correct answer: D

Rationale: The Resiliency model of family stress, adjustment, and adaptation is the appropriate theory in this scenario. This model focuses on identifying risks and protective factors that help families achieve positive outcomes despite challenges. Duvall's developmental theory primarily focuses on family life cycle stages, Friedman's structural functional theory emphasizes the interdependence of family members, and Von Bertalanffy's general system theory applied to families looks at the family as a dynamic system. These theories do not specifically address the concept of resilience and adaptation in the face of stressors like homelessness.

3. A child has been diagnosed with nephrotic syndrome, and a nurse is providing care. What is the priority nursing intervention?

• A. Administering diuretics
• B. Monitoring urine output
• C. Administering corticosteroids
• D. Restricting fluid intake

Correct answer: B

Rationale: The priority nursing intervention when caring for a child with nephrotic syndrome is monitoring urine output. This is essential for assessing kidney function and managing the condition effectively. Administering diuretics (Choice A) may be a part of the treatment plan but should not be the priority over monitoring urine output. Administering corticosteroids (Choice C) may also be a treatment for nephrotic syndrome, but monitoring urine output takes precedence. Restricting fluid intake (Choice D) may be necessary in some cases, but it is not the priority intervention compared to monitoring urine output for early detection of changes in kidney function.

4. A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse’s most appropriate response?

• A. Praise the parent for the decision and encourage the plan.
• B. Ask for more specific information related to the developmental delays.
• C. Advise the parent to have the healthcare provider help choose an appropriate program.
• D. Explain that this may be a premature action and the developmental delays could disappear.

Correct answer: B

Rationale: The most appropriate response for the nurse in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the situation, offer appropriate support, and provide guidance tailored to the child's specific needs. Praising the parent or encouraging the plan without understanding the full context may not be beneficial. Advising the parent to have the healthcare provider help choose a program assumes the parent has not already involved the healthcare provider, which may not be the case. Explaining that the developmental delays could disappear is not appropriate as it may give false hope or minimize the parent's concerns.

5. An instructor is developing a plan for a class of nursing students on various skin disorders. When describing urticaria, what would the instructor include?

• A. It is a type IV hypersensitivity reaction.
• B. Histamine release leads to vasodilation.
• C. Wheals appear first followed by erythema.
• D. The nonpruritic rash blanches with pressure.

Correct answer: B

Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction, not type IV. When triggered, histamine release leads to vasodilation, causing characteristic wheals. Wheals are typically followed by erythema. The rash in urticaria is pruritic and does blanch with pressure, unlike the nonpruritic rash described in choice D. Therefore, the most appropriate description of urticaria includes histamine release and vasodilation, as stated in choice B.

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