Nursing Elites

1. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

2. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?

• A. Administering a cough suppressant
• B. Inserting a Foley catheter
• C. Administering an anti-diarrheal
• D. Monitoring urinary output

Correct answer: B

Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.

3. A 4-year-old client with intractable seizures has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided pain. Which possible complication to this diet does the nurse suspect?

• A. Appendicitis
• B. Bowel obstruction
• C. Urinary tract infection
• D. Kidney stones

Correct answer: D

Rationale: The ketogenic diet increases the risk of kidney stones.

4. After administering Gardasil, the HPV vaccine, to an 11-year-old girl, the healthcare provider informs the parent that routine screening with which diagnostic test is needed?

• A. Beta hCG
• B. Chlamydia test
• C. PAP test
• D. Mammogram

Correct answer: C

Rationale: Following the administration of Gardasil, the HPV vaccine, routine screening with a PAP test is necessary. While Gardasil protects against certain types of HPV, it does not cover all strains that could lead to cervical cancer. Therefore, individuals who have received the vaccine should still undergo regular PAP tests to screen for cervical abnormalities caused by other HPV strains.

5. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?

• A. Hypoalbuminemia
• B. Hyperkalemia
• C. Polyuria
• D. Hyperglycemia

Correct answer: A

Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.

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