Nursing Elites

1. A parent of a child with celiac disease is receiving teaching from a nurse. Which of the following statements should the nurse make?

• A. You should give your child vitamin supplements that contain iron.
• B. Your child will need a gluten-free diet.
• C. Your child should consume large amounts of dietary fiber.
• D. Your child can resume eating whole wheat bread.

Correct answer: B

Rationale: The correct answer is B. Celiac disease requires a strict gluten-free diet to manage the condition effectively. Gluten-containing foods like wheat, barley, and rye must be avoided to prevent intestinal damage and symptoms in individuals with celiac disease. Therefore, the nurse should emphasize the importance of a gluten-free diet to the parent of the child with celiac disease.

2. A patient who has PUD and is receiving magnesium hydroxide (MOM) is experiencing an increased number of BM. Which is the nurse’s priority action?

• A. Ask the HCP for a reduction in dose
• B. Encourage the patient to increase dietary fiber
• C. Administer the drug with an aluminum hydroxide antacid
• D. Instruct patient to keep an accurate stool count

Correct answer: C

Rationale: MOM is a rapid-acting antacid with a prominent adverse effect of diarrhea. To compensate, it usually is administered in combo with aluminum hydroxide which promotes constipation. A reduction in dose might be necessary if the diarrhea is severe, but this is not a priority action. Increasing dietary fiber and keeping a stool count are appropriate actions to implement after adding an antacid to counteract the diarrhea effect.

3. When preparing an adolescent for a lumbar puncture, which of the following actions should the nurse take?

• A. Place a cardiac monitor on the adolescent prior to the procedure
• B. Apply topical analgesic cream to the site one hour prior to the procedure
• C. Keep the adolescent in a semi-Fowler's position for 4 hours following the procedure
• D. Restrict fluids for 2 hours following the procedure

Correct answer: B

Rationale: The correct action for the nurse when preparing an adolescent for a lumbar puncture is to apply topical analgesic cream to the site one hour before the procedure. This helps reduce pain experienced during the lumbar puncture, making the procedure more comfortable for the adolescent. Placing a cardiac monitor on the adolescent is not necessary for a lumbar puncture. Keeping the adolescent in a semi-Fowler's position for 4 hours following the procedure is not a standard practice after a lumbar puncture. Restricting fluids for 2 hours following the procedure is not a requirement for a lumbar puncture preparation.

4. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

5. What is the last step in interpersonal reasoning?

• A. Choose a response or mode sequence
• B. Gather Feedback
• C. Anticipate
• D. Determine if a mode shift is required

Correct answer: B

Rationale: The last step in interpersonal reasoning involves gathering feedback. Once you have gone through the process of anticipating, choosing a response or mode sequence, and determining if a mode shift is required, the final step is to gather feedback to assess the effectiveness of your interaction and make any necessary adjustments.

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