Nursing Elites

1. When caring for a child diagnosed with bronchiolitis, what is the priority nursing intervention?

• A. Administering bronchodilators
• B. Providing respiratory therapy
• C. Monitoring oxygen saturation
• D. Encouraging fluid intake

Correct answer: B

Rationale: The priority nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention aims to maintain airway patency, optimize oxygenation, and support effective breathing. Administering bronchodilators, though important, may not be the initial priority as respiratory therapy takes precedence in ensuring adequate oxygenation and ventilation. Monitoring oxygen saturation is crucial but is usually part of the ongoing assessment following the initiation of respiratory therapy. Encouraging fluid intake is essential for hydration but is not the priority intervention when addressing the respiratory distress associated with bronchiolitis.

2. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Meals should be eaten at home.
• B. Foods should be weighed using a gram scale.
• C. A ready source of glucose should be available.
• D. Specific foods should be cooked for the adolescent.

Correct answer: C

Rationale: The correct answer is C: A ready source of glucose should be available. When managing type 1 diabetes, it is crucial to have a quick source of glucose readily available in case of hypoglycemia. This ensures that the adolescent can quickly raise their blood sugar levels to prevent complications. Choices A, B, and D are incorrect as they do not address the immediate need for glucose in managing hypoglycemia. While it is important for meals to be consumed regularly and in a controlled manner, specifying that they should be eaten at home or foods weighed using a gram scale is not as critical as ensuring a quick source of glucose in emergency situations.

3. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?

• A. Cellular metabolism is unstable in young children.
• B. The proportion of water in the body is less than in adults.
• C. Renal function is immature in children until they reach school age.
• D. The extracellular fluid requirement per unit of body weight is greater than in adults.

Correct answer: D

Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect because cellular metabolism being unstable is not the primary explanation for the symptoms described. Choice B is incorrect as the proportion of water in the body alone does not fully explain the increased risk of dehydration in infants. Choice C is incorrect because while renal function is immature in children, it is not the most relevant factor in this scenario compared to the increased fluid requirements.

4. During the health assessment of a school-age child, on which problem would the nurse focus more attention based on the child's developmental level?

• A. Infections
• B. Poisonings
• C. Risk-taking behaviors
• D. Accidents and injuries

Correct answer: D

Rationale: During the school-age years, children are more physically active and curious, which increases their risk of accidents and injuries. This developmental stage is characterized by increased exploration and engagement in physical activities. While infections and poisonings are important health concerns, school-age children are more likely to be affected by accidents and injuries due to their active nature. Risk-taking behaviors may become more prevalent in adolescence rather than during the school-age period, making it a less likely focus for the nurse during the health assessment of a school-age child.

5. A nurse is teaching a class about immunizations to members of a grammar school’s Parent-Teachers Association. Which childhood disease is the nurse discussing when explaining that it is a viral disease that starts with malaise and a highly pruritic rash that begins on the abdomen, spreads to the face and proximal extremities, and can result in grave complications?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is C, Chickenpox (varicella). Chickenpox is a viral disease characterized by a highly pruritic rash that typically starts on the abdomen and then spreads to other parts of the body, including the face and proximal extremities. It can lead to complications such as pneumonia and encephalitis. Rubella (German measles) presents with a mild rash and swollen lymph nodes; Rubeola (measles) also presents with a rash but starts on the face before spreading downwards; Scarlet fever is caused by Group A Streptococcus bacteria and is characterized by a rash, fever, and sore throat.

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