Nursing Elites

1. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?

• A. Ibuprofen, an anti-inflammatory agent
• B. Furosemide (Lasix), a diuretic
• C. Ciprofloxacin (Cipro), an antibiotic
• D. Cyclophosphamide (Cytoxan), an immunosuppressant

Correct answer: B

Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.

2. A nurse provides dietary teaching to the guardian of a school-age child with cystic fibrosis. Which statement should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day.
• B. You should decrease your child's dietary fat intake to less than 10% of their caloric intake.
• C. You should restrict your child's calorie intake to 1,200 per day.
• D. You should give your child a multivitamin once weekly.

Correct answer: A

Rationale: The correct answer is A. High-protein meals and snacks are essential for children with cystic fibrosis due to their increased nutritional needs. Protein helps in maintaining muscle mass and overall health in individuals with cystic fibrosis, making it crucial to include in their diet. Choices B, C, and D are incorrect because decreasing dietary fat intake to less than 10% of caloric intake, restricting calorie intake to 1,200 per day, and giving a multivitamin once weekly are not appropriate dietary recommendations for a child with cystic fibrosis.

3. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

4. Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?

• A. Bacteriuria and increased specific gravity
• B. Hematuria and proteinuria
• C. Proteinuria and decreased specific gravity
• D. Bacteriuria and hematuria

Correct answer: B

Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, the presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.

5. What is the goal of pharmacologic therapy in the treatment of Parkinson’s disease?

• A. To increase the amount of acetylcholine at the pre-synaptic neurons
• B. To reduce the amount of dopamine available in the substantia nigra
• C. To balance cholinergic and dopaminergic activity in the brain
• D. To block dopamine receptors in pre-synaptic and post-synaptic neurons

Correct answer: C

Rationale: Parkinson’s disease results from a decrease in dopaminergic (inhibitory) activity, leaving an imbalance with too much cholinergic (excitatory) activity. With an increase in dopamine, the neurotransmitter activity becomes more balanced, and symptoms are controlled.

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