Nursing Elites

1. When a patient is taking glucocorticoids and digoxin, which electrolyte should the nurse prioritize monitoring?

• A. Calcium
• B. Magnesium
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The nurse should primarily monitor potassium levels in a patient taking glucocorticoids and digoxin. Glucocorticoids can lead to potassium loss, potentially increasing the risk of digoxin toxicity. Additionally, glucocorticoids may worsen hypokalemia induced by diuretics like thiazides and loops. While calcium, magnesium, and sodium are important electrolytes to monitor in various clinical situations, they are not the priority in this specific scenario of a patient on glucocorticoids and digoxin.

2. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?

• A. Clay-colored stools and dark urine
• B. History of early passage of meconium in the newborn period
• C. History of chronic, progressive constipation and failure to gain weight
• D. Continual bouts of foul-smelling diarrhea

Correct answer: C

Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.

3. What does the abbreviation BPD mean in a medical chart?

• A. Brain premature deficit
• B. Bronchiopulmonary dysplasia
• C. Bilateral partial disorder
• D. Baby post delivery

Correct answer: B

Rationale: The correct answer is B: Bronchiopulmonary Dysplasia. BPD refers to a chronic lung disorder that primarily affects premature infants or those who have been on ventilator support. It is characterized by abnormal development of the lungs and breathing difficulties. This abbreviation is commonly seen on medical charts in neonatal and pediatric settings.

4. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

5. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

• A. Massive proteinuria, hypoalbuminemia, and edema
• B. Hematuria, bacteriuria, and weight gain
• C. Decreased urine specific gravity and increased urinary output
• D. Gross hematuria, albuminuria, and fever

Correct answer: A

Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.

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