Nursing Elites

1. A nurse is planning care to address nutritional needs for a preschooler with cystic fibrosis. Which interventions should the nurse include in plans?

• A. Administer pancreatic enzymes 2 hours after meals.
• B. Monitor and adjust the use of pancreatic enzymes if steatorrhea develops.
• C. Encourage adequate fluid intake based on the child's needs.
• D. Increase fat content in the child's diet to 40% of total calories.

Correct answer: D

Rationale: Increasing fat content in the diet is essential for meeting the high energy needs of a child with cystic fibrosis. Cystic fibrosis impairs the absorption of nutrients, particularly fats, so increasing the fat content in the child's diet to 40% of total calories helps ensure adequate caloric intake. This intervention can help maintain the child's nutritional status and support growth and development.

2. Why should a healthcare professional take time to get to know the things a family does together, their weekly routine, and an explanation of family dynamics?

• A. Involvement in the family is central to best practice
• B. It is not necessary, but it is beneficial
• C. To gather demographic information for documentation purposes
• D. To assess if they have values that align with the practitioner's

Correct answer: A

Rationale: Understanding the activities, routines, and dynamics of a family is crucial for a healthcare professional to provide holistic care. By gaining insight into the family's lifestyle and relationships, the professional can tailor interventions that are better integrated into the family's daily life, fostering more effective therapy outcomes and enhancing the overall quality of care provided. Choice A is the correct answer because involvement in the family is indeed central to best practice in healthcare. Choices B, C, and D are incorrect because simply gathering demographic information, assessing values alignment, or considering it as optional fails to recognize the importance of understanding the family dynamics for effective care delivery.

3. How would you best evaluate the clinical usefulness of a test?

• A. Decide on using a single test for all clients and families
• B. Consider what needs to be collected and discuss with colleagues
• C. Ask the family for a test suggestion
• D. Read the statistical methods used to validate the scores

Correct answer: B

Rationale: When evaluating the clinical usefulness of a test, the best approach is to consider what specific information needs to be collected based on the clients' needs. Discussing these considerations with colleagues helps in ensuring that the chosen test is appropriate and beneficial for the individuals being assessed. Choice A is incorrect as using a single test for all clients may not account for individual differences. Choice C is incorrect as the family's suggestion alone may not align with clinical needs. Choice D is incorrect as understanding statistical methods alone may not fully capture the clinical utility of a test.

4. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone?

• A. Can interfere with the treatment for nephrosis.
• B. Require that the child have antibiotic coverage.
• C. Can be given in smaller, divided doses.
• D. Should be delayed.

Correct answer: D

Rationale: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

5. 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.

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