Nursing Elites

1. 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.

2. Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?

• A. Headache, hematuria, and vertigo
• B. Foul-smelling urine, elevated blood pressure (BP), and hematuria
• C. Urgency, dysuria, and fever
• D. Severe flank pain, nausea, and headache

Correct answer: C

Rationale: Preschool-age children with a urinary tract infection commonly present with urgency (feeling the need to urinate urgently), dysuria (painful urination), and fever. These symptoms are indicative of a UTI in this age group and should prompt further assessment and intervention by the nurse. Choice A is incorrect because headache and vertigo are not typical symptoms of UTI in preschool-age children. Choice B is incorrect because while foul-smelling urine and hematuria can be present in UTI, elevated blood pressure is not a common finding in this condition. Choice D is incorrect as severe flank pain and nausea are not typical manifestations of UTI in preschool-age children.

3. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

4. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?

• A. Store the insulin in the refrigerator after each use.
• B. Rotate injection sites each time you give the injection.
• C. You should give the insulin at room temperature.
• D. Administer the insulin within 30 minutes of each meal.

Correct answer: C

Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.

5. When caring for an infant with respiratory syncytial virus (RSV), which of the following actions should the nurse take?

• A. Administer antibiotics IM once per day.
• B. Initiate droplet precautions.
• C. Place the infant in a negative-pressure isolation room.
• D. Suction the nasopharynx as needed.

Correct answer: D

Rationale: When caring for an infant with respiratory syncytial virus (RSV), maintaining a patent airway is crucial. Suctioning the nasopharynx as needed helps clear secretions, prevent airway obstruction, and promote effective breathing. This intervention can aid in improving the infant's respiratory status and overall comfort. Administering antibiotics IM once per day (Choice A) is not indicated for RSV as it is caused by a virus, not bacteria. Initiating droplet precautions (Choice B) is important to prevent the spread of respiratory infections like RSV, but directly caring for the infant involves more specific interventions. Placing the infant in a negative-pressure isolation room (Choice C) is generally reserved for airborne infections, not RSV which spreads through respiratory droplets.

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