Nursing Elites

1. At 7 AM, a nurse receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?

• A. Encourage the adolescent to start exercising.
• B. Ask the adolescent to obtain an immediate glucometer reading.
• C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
• D. Tell the adolescent that the prescribed dose of rapid acting insulin should be administered.

Correct answer: D

Rationale: Rapid acting insulin will help lower the elevated blood glucose level quickly.

2. When assessing a 2-year-old child with abdominal pain and adequate perfusion, general guidelines include

• A. examining the child in the parent's arms
• B. palpating the painful area of the abdomen first
• C. placing the child supine and palpating the abdomen
• D. separating the child from the parent to ensure a reliable examination

Correct answer: A

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach helps reduce anxiety, provide comfort, and establish trust with the child. Palpating the painful area of the abdomen first (Choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (Choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent (Choice D) can exacerbate the child's anxiety and hinder the examination process. Therefore, examining the child in the parent's arms is the most appropriate approach in this scenario.

3. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?

• A. Erythematous papulovesicular rash
• B. Dry, red, scaly rash with lichenification
• C. Pustular vesicles with honey-colored exudates
• D. Hypopigmented oval scaly lesions

Correct answer: B

Rationale: In atopic dermatitis, the characteristic presentation includes a dry, red, scaly rash with lichenification. This appearance is due to chronic inflammation and scratching. Choice A is incorrect as erythematous papulovesicular rash is more indicative of conditions like contact dermatitis. Choice C is incorrect as pustular vesicles with honey-colored exudates are seen in impetigo. Choice D is incorrect as hypopigmented oval scaly lesions are more characteristic of tinea versicolor.

4. A healthcare provider is assessing a child with suspected pneumonia. What clinical manifestation is the provider likely to observe?

• A. Cough
• B. Diarrhea
• C. Rash
• D. Vomiting

Correct answer: A

Rationale: A cough is a common clinical manifestation of pneumonia. Pneumonia often presents with symptoms such as cough, fever, chest pain, and difficulty breathing. The inflammation and infection in the lungs lead to the characteristic cough observed in patients with pneumonia. Diarrhea, rash, and vomiting are not typically associated with pneumonia and are less likely to be observed in a child with this condition.

5. What finding would lead the nurse to suspect that a child has Turner syndrome?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a key feature seen in Turner syndrome, a genetic condition that occurs in females due to a complete or partial absence of one of the X chromosomes. This physical trait is caused by excess skin on the neck, giving it a webbed appearance. Microcephaly (Choice B) is a condition characterized by a smaller than average head size and is not typically associated with Turner syndrome. Gynecomastia (Choice C) refers to breast enlargement in males and is not a common finding in Turner syndrome, which affects females. Cognitive delay (Choice D) is not a specific characteristic of Turner syndrome, as the syndrome primarily affects physical development and may not necessarily impact cognitive abilities.

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