Nursing Elites

1. When teaching parents about preventing childhood obesity, what should the nurse recommend?

• A. Encourage high-calorie snacks
• B. Limit screen time
• C. Encourage fast food as a treat
• D. Allow the child to eat freely

Correct answer: B

Rationale: Limiting screen time is a crucial recommendation to prevent childhood obesity. Excessive screen time is associated with sedentary behavior and increased consumption of unhealthy snacks, leading to weight gain. Encouraging high-calorie snacks (Choice A) contradicts the goal of preventing obesity. While fast food as a treat (Choice C) can be consumed occasionally, it should not be encouraged as a regular practice. Allowing the child to eat freely (Choice D) without restrictions can lead to overeating and unhealthy dietary habits, contributing to obesity risk.

2. The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?

• A. Interrupted family process related to the child's diagnosis
• B. Deficient knowledge related to the genetic disorder
• C. Grieving related to the child's poor prognosis
• D. Ineffective coping related to stress from providing care

Correct answer: C

Rationale: The correct nursing diagnosis would be 'Grieving related to the child's poor prognosis.' Trisomy 18 is associated with a poor prognosis, and families often experience feelings of grief and loss when dealing with such a diagnosis. The choice 'Interrupted family process' does not directly address the emotional response to the prognosis. 'Deficient knowledge' may be a concern but does not address the emotional aspect of dealing with a poor prognosis. 'Ineffective coping related to stress from providing care' focuses more on the caregiver's ability to cope rather than the family's response to the child's condition.

3. A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?

• A. Dry, hacking cough
• B. Inspiratory stridor
• C. Nasal congestion
• D. Severe coughing spells

Correct answer: D

Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.

4. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but while waiting for the administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

• A. notify the practitioner
• B. measure abdominal girth
• C. auscultate for bowel sounds
• D. take vital signs, including blood pressure

Correct answer: A

Rationale: The passage of a normal brown stool in a child with intussusception could indicate spontaneous reduction of the intussusception. This change in the patient's condition is significant, requiring prompt notification of the practitioner for further evaluation and management. While measuring abdominal girth (Choice B) is important for assessing abdominal distention, it is not the priority when a potential spontaneous reduction may have occurred. Auscultating for bowel sounds (Choice C) and taking vital signs, including blood pressure (Choice D), are routine nursing assessments but do not address the immediate need to inform the practitioner of a possible change in the patient's condition that necessitates urgent attention.

5. What treatment should the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while at a basketball game?

• A. Call your parents immediately.
• B. Buy a soda and hamburger to eat.
• C. Administer insulin as soon as possible.
• D. Leave the arena and rest until the symptoms subside.

Correct answer: B

Rationale: When an adolescent with type 1 diabetes experiences an insulin reaction, it is essential to quickly raise their blood sugar levels. Buying a soda and a hamburger to eat is the best choice in this situation as it provides a fast-acting source of sugar to counteract hypoglycemia. Calling parents immediately may cause a delay in receiving appropriate treatment. Administering insulin would further lower blood sugar levels, worsening the situation. Leaving the arena and resting would not address the immediate need to raise blood sugar levels.

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