Nursing Elites

1. James is an 18-month-old child who has had a cough for 7 days with no general danger signs, a temperature of 37.5°C, and a respiratory rate of 41 breaths per minute. How will you classify James' breathing?

• A. Slow breathing
• B. Fast breathing
• C. Normal breathing
• D. Very fast breathing

Correct answer: C

Rationale: The correct answer is 'Normal breathing.' A respiratory rate of 41 breaths per minute is considered normal for an 18-month-old child. Choices A, B, and D are incorrect because a respiratory rate of 41 breaths per minute falls within the normal range for a child of James' age and does not indicate slow, fast, or very fast breathing.

2. The healthcare professional is planning a community health fair. Which of the following topics should be given the highest priority?

• A. blood pressure screening
• B. diabetes education
• C. smoking cessation
• D. nutrition and weight management

Correct answer: A

Rationale: In planning a community health fair, the highest priority should be given to blood pressure screening. This is because hypertension is a common and serious health issue that often goes undetected. Identifying individuals with high blood pressure early can lead to timely interventions and management, potentially preventing severe complications such as heart disease or stroke. While topics like diabetes education, smoking cessation, and nutrition are important, addressing blood pressure screening first aligns with the goal of early detection and prevention of a prevalent health concern.

3. A client with bipolar disorder is receiving lithium (Lithobid). The nurse should monitor the client for which of the following side effects?

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Lithium can lead to hyponatremia by affecting sodium balance in the body. Hypernatremia (Choice A) is unlikely with lithium use. Hyperglycemia (Choice C) and hypercalcemia (Choice D) are not typically associated with lithium therapy for bipolar disorder.

4. The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?

• A. Rapid bounding pulse
• B. Temperature of 38.5 degrees Celsius
• C. Profuse diaphoresis
• D. Slow, irregular respirations

Correct answer: D

Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.

5. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

• A. Congenital cardiac defects
• B. An acute febrile illness
• C. Prolonged hypoxemia
• D. Severe multiple trauma

Correct answer: C

Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.

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