Nursing Elites

1. A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?

• A. Administer antibiotics as prescribed.
• B. Maintain the child on NPO status.
• C. Monitor the child's intake and output.
• D. Implement seizure precautions.

Correct answer: D

Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety. Administering antibiotics as prescribed is essential in treating bacterial meningitis, but seizure precautions take precedence due to the immediate risk of injury. Maintaining NPO status and monitoring intake and output are important aspects of care but are not the priority when considering the risk of seizures.

2. A healthcare professional is planning care for an infant with hyperbilirubinemia receiving phototherapy. Which of the following actions should the healthcare professional include in the plan?

• A. Dress the infant in light, breathable clothing.
• B. Turn and reposition the infant every 4 hours.
• C. Offer the infant frequent, small feedings.
• D. Avoid using lotions on the infant's skin.

Correct answer: B

Rationale: Turning and repositioning the infant every 4 hours is essential to prevent pressure sores and ensure uniform exposure to phototherapy. This practice helps prevent skin breakdown and ensures the effectiveness of the phototherapy in treating hyperbilirubinemia. Dressing the infant in light, breathable clothing (Choice A) is generally a good practice but not directly related to the effectiveness of phototherapy. Offering frequent, small feedings (Choice C) is important for infant nutrition but does not directly impact the phototherapy. Avoiding lotions on the infant's skin (Choice D) is recommended to prevent interference with the phototherapy but is not the most critical action to include in the care plan.

3. A child is being cared for by a nurse and has rheumatic fever. Which of the following actions should the nurse plan to take?

• A. Administer aspirin to the child as prescribed based on the healthcare provider's instructions.
• B. Encourage adequate fluid intake for the child.
• C. Elevate the child's joints and provide warm compresses.
• D. Monitor the child's heart rate for dysrhythmias.

Correct answer: D

Rationale: Rheumatic fever can lead to cardiac complications, such as dysrhythmias. Therefore, it is essential for the nurse to monitor the child's heart rate closely for any signs of dysrhythmias. This will help in early identification and prompt management of potential cardiac issues associated with rheumatic fever. Choices A, B, and C are not the priority actions in this scenario. While aspirin may be used in the treatment of rheumatic fever, monitoring for cardiac complications takes precedence. Encouraging fluid intake and providing warm compresses are helpful interventions but do not directly address the cardiac risks associated with rheumatic fever.

4. Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?

• A. Carrots and green, leafy vegetables
• B. Spaghetti and meat sauce with breadsticks
• C. Hamburger on a bun and cherry gelatin
• D. Chips, cold cuts, and canned foods

Correct answer: A

Rationale: Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia. Therefore, this choice requires further instruction by the nurse to prevent exacerbating the child's condition.

5. For which patient diagnosis would a prescription for nifedipine be least appropriate?

• A. Angina Pectoris
• B. Essential HTN
• C. Atrial Fibrillation
• D. Vasospastic Angina

Correct answer: C

Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.

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