Nursing Elites

1. When providing teaching to the family of a school-age child with juvenile idiopathic arthritis, which instruction should the nurse include?

• A. Limit the child's movement of the large joints.
• B. Encourage the child to perform independent self-care.
• C. Provide the child with a soft mattress for sleeping.
• D. Schedule a 2-hour daily nap for the child in the afternoon.

Correct answer: B

Rationale: Encouraging the child to perform independent self-care is essential when managing juvenile idiopathic arthritis. This instruction helps minimize pain and stiffness in the child's joints while promoting mobility and independence. It is crucial for the child to learn self-management skills early to cope better with the condition in the long term.

2. How would you best evaluate the clinical usefulness of a test?

• A. Decide on using a single test for all clients and families
• B. Consider what needs to be collected and discuss with colleagues
• C. Ask the family for a test suggestion
• D. Read the statistical methods used to validate the scores

Correct answer: B

Rationale: When evaluating the clinical usefulness of a test, the best approach is to consider what specific information needs to be collected based on the clients' needs. Discussing these considerations with colleagues helps in ensuring that the chosen test is appropriate and beneficial for the individuals being assessed. Choice A is incorrect as using a single test for all clients may not account for individual differences. Choice C is incorrect as the family's suggestion alone may not align with clinical needs. Choice D is incorrect as understanding statistical methods alone may not fully capture the clinical utility of a test.

3. A healthcare professional is assessing a child who has nephrotic syndrome. Which of the following findings should the healthcare professional expect?

• A. Hypotension
• B. Hyperglycemia
• C. Facial edema
• D. Weight gain

Correct answer: D

Rationale: In nephrotic syndrome, there is increased permeability of the glomerular filtration barrier, leading to protein loss in the urine. This results in hypoalbuminemia, causing fluid retention and edema. Therefore, weight gain due to fluid retention is a common finding in children with nephrotic syndrome.

4. A patient is prescribed fluconazole (Diflucan) for a vaginal yeast infection. The nurse should be concerned if the patient is also taking which medication?

• A. Losartan (Cozaar)
• B. Simvastatin (Zocor)
• C. Lisinopril (Zestril)
• D. Hydrochlorothiazide (HCTZ)

Correct answer: B

Rationale: When fluconazole is taken with statins like simvastatin, it can increase the levels of the statin in the blood, potentially leading to adverse effects such as muscle pain and weakness. Therefore, the nurse should be concerned if the patient is taking simvastatin along with fluconazole.

5. The nurse plans to closely monitor for which clinical manifestation after administering furosemide (Lasix)?

• A. Decrease pulse
• B. Decrease temperature
• C. Decrease BP
• D. Decrease respiratory rate.

Correct answer: C

Rationale: High-ceiling diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased BP. When BP drops, the pulse will probably increase rather than decrease.

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