Nursing Elites

1. During the oliguric phase of acute kidney injury, what intervention should be included in the plan of care for a child?

• A. Administer a loop diuretic.
• B. Provide a low-sodium diet.
• C. Weigh the child weekly.
• D. Provide a high-protein diet.

Correct answer: A

Rationale: During the oliguric phase of acute kidney injury, the priority is managing fluid balance. Administering a loop diuretic is crucial to promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly is important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase, as it can put additional stress on the kidneys.

2. 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.

3. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

4. What type of mode best describes Kasey's approach when meeting with the principal to change the cafeteria to better accommodate her client with difficulty eating in a noisy and distracting environment?

• A. Collaborating
• B. Instructing
• C. Advocating
• D. Encouraging

Correct answer: C

Rationale: Advocating best describes Kasey's approach in this scenario. Advocating involves presenting stories, research, and ideas to support and champion for a specific cause or individual, in this case, advocating for changes to better meet the child's needs in the cafeteria. Collaborating involves working together with others towards a common goal, instructing involves providing guidance or directions, and encouraging involves giving support or motivation, none of which fully capture Kasey's proactive and supportive advocacy actions in this context.

5. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?

• A. Change the ostomy pouch every day.
• B. Use baby wipes to clean the stoma.
• C. Avoid using soap to clean the stoma.
• D. Apply barrier ointment to the skin around the stoma.

Correct answer: D

Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.

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