Nursing Elites

1. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

2. A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?

• A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
• B. Reschedule the treatment for a later time
• C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
• D. Show the respiratory therapist to the playroom

Correct answer: C

Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.

3. The nurse is assessing a child with type 2 diabetes. The child is awake and alert with a serum glucose of 60 mg/dL. What action should the nurse take?

• A. Administer Insulin.
• B. Administer Epinephrine.
• C. Give 15 grams of carbohydrates.
• D. Give glucagon by injection.

Correct answer: C

Rationale: For a conscious child with mild hypoglycemia, giving 15 grams of fast-acting carbohydrates is the appropriate intervention. This can quickly raise blood glucose levels to prevent further complications. Administering insulin (Choice A) would further lower the glucose level, which is not suitable in this scenario. Administering epinephrine (Choice B) is not indicated for hypoglycemia. Glucagon (Choice D) is used for severe hypoglycemia with altered consciousness, not for mild cases where the child is awake and alert.

4. What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

• A. Reduce blood pressure
• B. Lower serum protein levels
• C. Minimize excretion of urinary protein
• D. Increase the ability of tissue to retain fluid

Correct answer: C

Rationale: The primary objective in managing MCNS is to minimize the excretion of urinary protein, which is responsible for the hypoalbuminemia and subsequent edema in these patients.

5. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?

• A. The child has recently been exposed to an infectious disease
• B. The child has symptoms of a cold but no fever
• C. The child is having intermittent episodes of diarrhea
• D. The child has a disorder that causes a deficient immune system

Correct answer: D

Rationale: A compromised immune system is a contraindication for the MMRV vaccine because it is a live attenuated vaccine and could potentially cause an infection in an immunocompromised child.

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