Nursing Elites

1. Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?

• A. If your blood glucose levels are controlled, you can switch to using pills.
• B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
• C. Your body does not make insulin, so the insulin injections help to replace it.
• D. The pills work on the adult pancreas; you can switch when you are 18.

Correct answer: C

Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.

2. What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?

• A. Oxygen, back slaps, and transport.
• B. Subdiaphragmatic thrusts until the object is expelled.
• C. Assisted ventilations, back slaps, and transport.
• D. Supplemental oxygen and transport.

Correct answer: D

Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.

3. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:

• A. allowing the parents to transport the child.
• B. offering oxygen and providing transport.
• C. rapidly cooling the child in cold water.
• D. keeping the child warm and providing transport.

Correct answer: B

Rationale: After a febrile seizure, the priority is to offer oxygen and provide transport to a medical facility. Oxygen may be necessary to ensure proper oxygenation, and medical evaluation is crucial to determine the cause of the seizure and prevent recurrence. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not indicated as the skin is already hot and moist. Therefore, offering oxygen and timely transportation to a healthcare facility is the most appropriate course of action. Allowing the parents to transport the child might delay necessary medical care, and keeping the child warm can exacerbate the existing heat. Rapidly cooling the child in cold water can lead to adverse effects, making it an inappropriate choice.

4. After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:

• A. 10 to 12 breaths/min.
• B. 12 to 20 breaths/min.
• C. 6 to 8 breaths/min.
• D. 8 to 10 breaths/min.

Correct answer: D

Rationale: The appropriate ventilation rate for an infant with an advanced airway is 8 to 10 breaths per minute.

5. A postpartum client asks the nurse about resuming sexual activity. What is the nurse's best response?

• A. You can resume sexual activity as soon as you feel ready.
• B. It is best to wait until your postpartum check-up before resuming sexual activity.
• C. You should wait at least 6 weeks before resuming sexual activity.
• D. It is safe to resume sexual activity once your lochia has stopped.

Correct answer: B

Rationale: The best response for the nurse is to advise the postpartum client to wait until the postpartum check-up before resuming sexual activity. This allows for complete healing to ensure the client's well-being and provides an opportunity to address any concerns with the healthcare provider. Choice A is incorrect because resuming sexual activity should be based on medical advice rather than personal readiness. Choice C is incorrect as the 6-week recommendation is a general guideline but individual circumstances may vary. Choice D is incorrect as the cessation of lochia is not the sole indicator for safe resumption of sexual activity.

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