Nursing Elites

1. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

2. A patient who has PUD and is receiving magnesium hydroxide (MOM) is experiencing an increased number of BM. Which is the nurse’s priority action?

• A. Ask the HCP for a reduction in dose
• B. Encourage the patient to increase dietary fiber
• C. Administer the drug with an aluminum hydroxide antacid
• D. Instruct patient to keep an accurate stool count

Correct answer: C

Rationale: MOM is a rapid-acting antacid with a prominent adverse effect of diarrhea. To compensate, it usually is administered in combo with aluminum hydroxide which promotes constipation. A reduction in dose might be necessary if the diarrhea is severe, but this is not a priority action. Increasing dietary fiber and keeping a stool count are appropriate actions to implement after adding an antacid to counteract the diarrhea effect.

3. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

• A. Massive proteinuria, hypoalbuminemia, and edema
• B. Hematuria, bacteriuria, and weight gain
• C. Decreased urine specific gravity and increased urinary output
• D. Gross hematuria, albuminuria, and fever

Correct answer: A

Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.

4. A healthcare provider is planning care for a child with hyperkalemia. Which manifestation associated with the documented hyperkalemia requires immediate intervention by the healthcare provider?

• A. Hyperthermia
• B. Respiratory distress
• C. Seizures
• D. Cardiac arrhythmias

Correct answer: D

Rationale: In hyperkalemia, cardiac arrhythmias are the most critical and life-threatening manifestation that requires immediate intervention. Hyperkalemia can lead to dangerous heart rhythm disturbances, potentially resulting in cardiac arrest. Prompt treatment is essential to stabilize the heart rhythm and prevent life-threatening complications. Hyperthermia, respiratory distress, and seizures are not typically associated with hyperkalemia and should be addressed, but cardiac arrhythmias pose the most urgent risk to the patient's life.

5. Which of the following is a key feature of the diagnosis of ASD according to the DSM V?

• A. Unusual responses to sensory input
• B. Social isolation
• C. Repetitive behaviors
• D. Delayed motor development

Correct answer: A

Rationale: In the DSM V, one of the key diagnostic criteria for Autism Spectrum Disorder (ASD) is unusual responses to sensory input. These atypical responses can include hypersensitivity or hyposensitivity to sensory stimuli, such as sound, touch, taste, or smell. These sensory processing differences are important in the diagnosis of ASD because they can significantly impact an individual's daily functioning and behavior. Social isolation and repetitive behaviors are associated features of ASD but are not the key diagnostic criteria according to the DSM V. Delayed motor development may be observed in some individuals with ASD, but it is not a key feature used for diagnosis in the DSM V.

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