Nursing Elites

1. A nurse is teaching a parent of a child who has asthma. Which of the following instructions should the nurse include?

• A. Use a peak flow meter daily.
• B. Administer the medication with meals.
• C. Provide a low-carbohydrate diet.
• D. Limit exposure to cold air.

Correct answer: A

Rationale: The nurse should instruct the parent to use a peak flow meter daily to monitor the child�s respiratory status and detect early signs of an asthma attack.

2. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?

• A. The dialysate is clear upon return.
• B. The volume of drained dialysate is less than the volume infused.
• C. The child is restless and eager to play.
• D. The child's vital signs remain consistent with those noted during infusion.

Correct answer: B

Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.

3. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

4. A caregiver is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching?

• A. I should secure the car seat using lower anchors and tethers instead of the seat belt
• B. I should position the car seat harness one inch above my baby's shoulders
• C. I will make sure that the car seat is placed at a 90-degree angle
• D. I will pad my baby's car seat with a blanket for traveling long distances

Correct answer: A

Rationale: The correct answer is A. Lower anchors and tethers, known as the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides a safer and more secure way of installing the car seat compared to using the seat belt alone. Using the lower anchors and tethers ensures proper installation and reduces the risk of car seat movement during travel, providing optimal protection for the infant. Choices B, C, and D are incorrect. Choice B is incorrect because the car seat harness should be positioned at or below the baby's shoulders, not above. Choice C is incorrect because the car seat should be positioned at the correct recline angle recommended by the car seat manufacturer, which may not necessarily be 90 degrees. Choice D is incorrect because adding padding like a blanket to the car seat is not recommended as it can interfere with the proper fit and function of the car seat, potentially compromising the safety of the infant.

5. During the oliguric phase of acute kidney injury, what intervention should be included in the plan of care for a child?

• A. Administer a loop diuretic.
• B. Provide a low-sodium diet.
• C. Weigh the child weekly.
• D. Provide a high-protein diet.

Correct answer: A

Rationale: During the oliguric phase of acute kidney injury, the priority is managing fluid balance. Administering a loop diuretic is crucial to promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly is important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase, as it can put additional stress on the kidneys.

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