Nursing Elites

1. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

• A. You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
• B. You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy.
• C. Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy.
• D. When using the peak expiratory flow meter, record your child's average of three readings.

Correct answer: C

Rationale: The nurse should inform the parent that the child will need pulmonary function tests every 12 to 24 months to assess lung function and response to treatment. These tests help evaluate the presence of lung disease, monitor disease progression, and assess the effectiveness of the current therapeutic regimen in managing asthma. Choice A is incorrect as salmeterol is not used for acute wheezing episodes but rather for long-term maintenance. Choice B is incorrect because weight monitoring is not directly related to inhaled corticosteroid therapy for asthma. Choice D is incorrect as peak expiratory flow meter readings should be recorded as instructed, not averaged.

2. When discussing the correction of hypospadias in a newborn, what does the nurse explain about this condition?

• A. No intervention is required as the defect will correct itself over time.
• B. Surgical repair of hypospadias is typically performed before 18 months of age.
• C. Corrective surgery is commonly postponed until preschool age.
• D. Repairing the defect does not increase the risk of testicular cancer.

Correct answer: B

Rationale: Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis. Surgical repair is the primary treatment for hypospadias and is usually recommended to be done before 18 months of age. This timing is preferred for optimal cosmetic and functional outcomes. Waiting until preschool age for corrective surgery may increase the complexity of the procedure and potential complications. Correcting hypospadias does not impact the risk of testicular cancer.

3. What side effect should the nurse include in the parent teaching for a child prescribed a baclofen pump for cerebral palsy?

• A. Diarrhea
• B. Hypertonia
• C. Hypotonia
• D. Restlessness

Correct answer: C

Rationale: When a child is prescribed a baclofen pump for cerebral palsy, one of the common side effects to include in parent teaching is hypotonia. Baclofen, a muscle relaxant, can lead to decreased muscle tone, resulting in hypotonia. It is important for parents to be aware of this potential side effect and know how to respond accordingly.

4. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?

• A. Offer Pedialyte between formula feedings.
• B. Feed the infant every 6 hours.
• C. Give diluted apple juice if the infant becomes dehydrated.
• D. Switch to soy-based formula permanently.

Correct answer: A

Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.

5. A caregiver is learning about administering digoxin to a toddler. Which statement by the caregiver indicates an understanding of the teaching?

• A. I will mix the medication with a small amount of juice.
• B. I will give the medication with meals.
• C. I will give a second dose if my child vomits.
• D. I will give my child water after giving the medication.

Correct answer: D

Rationale: The correct statement is D because giving the child water after administering digoxin helps ensure the medication is swallowed properly. Mixing the medication with juice (choice A) may affect its absorption. Giving the medication with meals (choice B) may interfere with its effectiveness. Administering a second dose if the child vomits (choice C) is not recommended as it may lead to an overdose.

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