Nursing Elites

1. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?

• A. 5% dextrose infusion
• B. Normal saline infusion
• C. NPH insulin infusion
• D. Potassium infusion

Correct answer: B

Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.

2. In contrast to the contractions associated with true labor, Braxton-Hicks contractions:

• A. generally follow rupture of the amniotic sac and occur with regularity.
• B. may be intensified by activity and are accompanied by a pink discharge.
• C. do not increase in intensity and are alleviated by a change in position.
• D. consistently become stronger and are not alleviated by changing position.

Correct answer: C

Rationale: Braxton-Hicks contractions are irregular and usually do not increase in intensity. Unlike true labor contractions, they tend to alleviate with a change in position, making option C the correct choice. Choices A, B, and D are incorrect because Braxton-Hicks contractions do not follow rupture of the amniotic sac, are not intensified by activity or accompanied by a pink discharge, and do not consistently become stronger or are not alleviated by changing position.

3. The word hormone is derived from the Greek 'hormao' meaning 'I excite or arouse.' Hormones communicate this effect through their unique chemical structures recognized by specific receptors on their target cells, their patterns of secretion, and their concentrations in the general or local circulation. Which of the following is NOT a function of hormones?

• A. Producing new offspring
• B. Promoting growth and enhancing beauty
• C. Maintaining body temperature
• D. Fighting infections

Correct answer: A

Rationale: Hormones play a crucial role in various bodily functions such as regulating metabolism, growth, and maintaining homeostasis. However, producing new offspring involves reproductive processes controlled by other systems in the body, not directly by hormones.

4. Jaundice in children can be either pathological or physiological. Which of these will you consider as more serious?

• A. Jaundice seen within 24 hours of life
• B. Jaundice seen at the palms and soles
• C. Jaundice appearing after 24 hours of life
• D. Jaundice seen after 14 days of life

Correct answer: A

Rationale: Jaundice seen within 24 hours of life is considered more serious in children as it can indicate pathological causes such as hemolytic disease or sepsis, which require prompt evaluation and management to prevent complications. Jaundice appearing within 24 hours of life is concerning due to the higher likelihood of severe conditions, while jaundice seen at the palms and soles is more likely due to physiological causes such as breast milk jaundice. Jaundice appearing after 24 hours or after 14 days of life may still require evaluation but is less urgent compared to jaundice within the first 24 hours.

5. What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?

• A. Oxygen, back slaps, and transport.
• B. Subdiaphragmatic thrusts until the object is expelled.
• C. Assisted ventilations, back slaps, and transport.
• D. Supplemental oxygen and transport.

Correct answer: D

Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.

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