Nursing Elites

1. A parent asks the school nurse how to eliminate lice from their child. What is the most appropriate response by the nurse?

• A. Cut the child's hair short to remove the nits
• B. Apply warm soaks to the head twice daily
• C. Wash the child's linen and clothing in a bleach solution
• D. Application of pediculicides

Correct answer: D

Rationale: Pediculicides are the recommended treatment for lice and should be used to eliminate the infestation.

2. Which of these clients, all in the terminal stage of cancer, is least appropriate to suggest the use of patient-controlled analgesia (PCA) with a pump?

• A. A young adult with a history of Down syndrome
• B. A teenager who reads at a 4th-grade level
• C. An elderly client with numerous arthritic nodules on the hands
• D. A preschooler with intermittent alertness

Correct answer: D

Rationale: The correct answer is D, a preschooler with intermittent alertness. This client may not have the cognitive ability to effectively use a PCA pump due to their age and alertness level. They may not understand how to self-administer the analgesia. Choices A, B, and C are more appropriate candidates for PCA as they are likely to have better comprehension and ability to operate the PCA pump compared to a preschooler with intermittent alertness.

3. The nurse is caring for a 7-year-old with acute glomerulonephritis (AGN). Findings include moderate edema and oliguria. Serum blood urea nitrogen and creatinine are elevated. What dietary modifications are most appropriate?

• A. Decreased carbohydrates and fat
• B. Decreased sodium and potassium
• C. Increased potassium and protein
• D. Increased sodium and fluids

Correct answer: B

Rationale: The correct answer is 'Decreased sodium and potassium.' In acute glomerulonephritis, managing edema and oliguria is crucial. Reducing sodium and potassium intake helps achieve this by decreasing fluid retention and workload on the kidneys. Choice A, 'Decreased carbohydrates and fat,' is not directly related to managing AGN. Choice C, 'Increased potassium and protein,' is incorrect as increasing potassium can be harmful in kidney conditions. Choice D, 'Increased sodium and fluids,' is also incorrect as it can exacerbate edema and hypertension in AGN.

4. The nurse is assessing a client 2 hours postoperatively after a femoral popliteal bypass. The upper leg dressing becomes saturated with blood. The nurse's first action should be to

• A. Wrap the leg with elastic bandages
• B. Apply pressure at the bleeding site
• C. Reinforce the dressing and elevate the leg
• D. Remove the dressings and re-dress the incision

Correct answer: B

Rationale: In this scenario where the upper leg dressing becomes saturated with blood post-femoral popliteal bypass, the nurse's first action should be to apply pressure at the bleeding site. Applying pressure is essential to control hemorrhage and prevent further blood loss. Choice A is incorrect as wrapping the leg with elastic bandages would not address the immediate issue of controlling the bleeding. Choice C is incorrect because reinforcing the dressing and elevating the leg should come after controlling the bleeding. Choice D is incorrect as removing the dressings and re-dressing the incision should only be done after the bleeding is under control to prevent excessive blood loss.

5. A nurse is reinforcing teaching with a client who has Crohn's Disease and is experiencing frequent cramping and diarrhea. Which of the following statements should the nurse include in the teaching?

• A. Increase your caloric intake by eating foods high in protein.
• B. Include fresh fruits and vegetables at each meal.
• C. Maintain your weight by eating high-fat foods.
• D. Drink whole milk to ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Increasing caloric intake by eating foods high in protein can help Crohn's Disease patients maintain their weight and manage symptoms. Choice B is incorrect because fresh fruits and vegetables may exacerbate symptoms due to their high fiber content. Choice C is incorrect as high-fat foods can be difficult to digest and may worsen symptoms. Choice D is incorrect because whole milk can be problematic for individuals with Crohn's Disease due to its high fat content.

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