Nursing Elites

1. A 7-year-old child with a diagnosis of type 1 diabetes mellitus is under the care of a nurse. What is the priority nursing intervention?

• A. Administering insulin as prescribed
• B. Monitoring blood glucose levels
• C. Teaching the child how to self-administer insulin
• D. Encouraging regular exercise

Correct answer: B

Rationale: The priority nursing intervention for a 7-year-old child with type 1 diabetes mellitus is monitoring blood glucose levels. This is crucial for managing and adjusting insulin therapy to maintain blood glucose within the target range. Administering insulin as prescribed is important but should be based on monitoring blood glucose levels. Teaching the child how to self-administer insulin may be appropriate for older children but may not be the priority for a 7-year-old. Encouraging regular exercise is a valuable aspect of diabetes management but is not the immediate priority over monitoring blood glucose levels.

2. A child with a diagnosis of leukemia is receiving chemotherapy. What is the most important nursing intervention?

• A. Monitor for signs of infection
• B. Monitor for signs of bleeding
• C. Monitor for signs of dehydration
• D. Monitor for signs of pain

Correct answer: A

Rationale: The most important nursing intervention for a child with leukemia receiving chemotherapy is to monitor for signs of infection. Chemotherapy suppresses the immune system, putting the child at a higher risk of developing infections. Early detection and prompt treatment of infections are crucial to prevent complications and improve outcomes. Monitoring for signs of bleeding (choice B), dehydration (choice C), and pain (choice D) are also important aspects of care, but in this scenario, the priority is to prevent and manage infections due to the compromised immune system.

3. The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.

• A. A family consists of parents and their offspring living together.
• B. A family is whatever the child and family say it is.
• C. A family is two or more people related or unrelated who are living together.
• D. A family is two or more genetically related persons living together with separate roles.

Correct answer: B

Rationale: Given the diversity of families in today's society, some believe that family should be defined as whatever the child and family say it is.

4. What finding would lead the nurse to suspect that a child has Turner syndrome?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a key feature seen in Turner syndrome, a genetic condition that occurs in females due to a complete or partial absence of one of the X chromosomes. This physical trait is caused by excess skin on the neck, giving it a webbed appearance. Microcephaly (Choice B) is a condition characterized by a smaller than average head size and is not typically associated with Turner syndrome. Gynecomastia (Choice C) refers to breast enlargement in males and is not a common finding in Turner syndrome, which affects females. Cognitive delay (Choice D) is not a specific characteristic of Turner syndrome, as the syndrome primarily affects physical development and may not necessarily impact cognitive abilities.

5. When assessing the perfusion status of a 2-year-old child with possible shock, which of the following parameters would be LEAST reliable?

• A. distal capillary refill
• B. systolic blood pressure
• C. skin color and temperature
• D. presence of peripheral pulses

Correct answer: B

Rationale: The correct answer is B: systolic blood pressure. In young children, systolic blood pressure is the least reliable parameter for assessing perfusion status. Factors such as anxiety, crying, and fear can significantly affect blood pressure measurements, leading to inaccuracies. Distal capillary refill, skin color and temperature, and presence of peripheral pulses are more reliable indicators of perfusion status in pediatric patients. Distal capillary refill assesses peripheral perfusion, skin color, and temperature reflect tissue perfusion, and the presence of peripheral pulses indicates blood flow to the extremities. Therefore, when evaluating a 2-year-old child with possible shock, focusing on parameters other than systolic blood pressure is crucial for an accurate assessment of perfusion status.

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