Nursing Elites

1. A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?

• A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
• B. Reschedule the treatment for a later time
• C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
• D. Show the respiratory therapist to the playroom

Correct answer: C

Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.

2. The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?

• A. Compress the bulb before insertion.
• B. Clear the mouth and pharynx before the nasal passages.
• C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
• D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.

Correct answer: B

Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.

3. The nurse is assessing a child with type 2 diabetes. The child is awake and alert with a serum glucose of 60 mg/dL. What action should the nurse take?

• A. Administer Insulin.
• B. Administer Epinephrine.
• C. Give 15 grams of carbohydrates.
• D. Give glucagon by injection.

Correct answer: C

Rationale: For a conscious child with mild hypoglycemia, giving 15 grams of fast-acting carbohydrates is the appropriate intervention. This can quickly raise blood glucose levels to prevent further complications. Administering insulin (Choice A) would further lower the glucose level, which is not suitable in this scenario. Administering epinephrine (Choice B) is not indicated for hypoglycemia. Glucagon (Choice D) is used for severe hypoglycemia with altered consciousness, not for mild cases where the child is awake and alert.

4. What is the primary goal in the treatment of a child with nephrotic syndrome?

• A. Decrease urine output
• B. Increase serum albumin
• C. Reduce proteinuria
• D. Increase blood pressure

Correct answer: C

Rationale: The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.

5. The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?

• A. Empty the mouth of pills, plants, or other material.
• B. Question the victim and witness.
• C. Place the child in a side-lying position.
• D. Call poison control.

Correct answer: D

Rationale: After ensuring the child's immediate survival needs are met with CPR, contacting poison control is critical to receive specific guidance on how to proceed with treatment. Other actions may be necessary depending on the situation but should follow contacting poison control.

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