Nursing Elites

1. When compensating for increased physical activity, what should the nurse teach a child with type 1 diabetes to do?

• A. Eat more food when planning to exercise more than usual.
• B. Take oral, not injectable insulin, on days of heavy exercise.
• C. Take insulin in the morning when extra exercise is anticipated.
• D. Eat foods that contain sugar to compensate for the extra exercise.

Correct answer: A

Rationale: The correct answer is to 'Eat more food when planning to exercise more than usual.' Increased physical activity requires more energy, so additional food intake is necessary to prevent hypoglycemia. Choice B is incorrect because the method of insulin administration should not be altered based on physical activity. Choice C is incorrect as insulin timing should be consistent rather than based on anticipated exercise. Choice D is incorrect since relying on foods with sugar can lead to unstable blood sugar levels, which is not ideal for managing diabetes during exercise.

2. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential for managing type 1 diabetes mellitus. This timing helps in assessing the effectiveness of insulin therapy, making adjustments to insulin doses, and preventing hyperglycemia and hypoglycemia. Option B is incorrect because it focuses on the method of obtaining blood samples rather than the timing of monitoring. Option C is incorrect as urine test strips are not recommended for accurate blood glucose monitoring in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when teaching about blood glucose monitoring.

3. When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:

• A. nondisjunction.
• B. X-linked recessive inheritance.
• C. genomic imprinting.
• D. autosomal dominant inheritance.

Correct answer: A

Rationale: The correct answer is A: nondisjunction. Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division leading to an extra copy of chromosome 21. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. Choices B, C, and D are incorrect. X-linked recessive inheritance refers to genetic disorders carried on the X chromosome, genomic imprinting involves gene expression based on parental origin, and autosomal dominant inheritance relates to disorders caused by a dominant gene on one of the non-sex chromosomes. In the case of trisomy 21, the cause is specifically related to the error in chromosome division, making nondisjunction the most appropriate answer.

4. A newborn is admitted to the neonatal intensive care unit (NICU) with choanal atresia. Which part of the infant’s body should the nurse assess?

• A. Rectum
• B. Nasopharynx
• C. Intestinal tract
• D. Laryngopharynx

Correct answer: B

Rationale: Choanal atresia is a congenital condition that presents with a blockage in the nasal passages at the junction of the nasal cavity and the nasopharynx. To assess and confirm the diagnosis of choanal atresia, the nurse should focus on assessing the nasopharynx. Choices A, C, and D are incorrect as choanal atresia specifically involves a blockage in the nasal passages, not the rectum, intestinal tract, or laryngopharynx. By assessing the nasopharynx, the severity of the obstruction can be determined, aiding in planning appropriate interventions for the newborn.

5. Why is the infant scheduled to receive the intramuscular polio vaccine instead of the oral vaccine, as asked by the parents?

• A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
• B. Both vaccines produce the same results and are equally safe, according to consensus.
• C. The intramuscular vaccine is preferred over the oral vaccine due to cost considerations, unless contraindicated.
• D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.

Correct answer: A

Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine over the oral vaccine due to its superior safety profile. Intramuscular administration ensures better immunogenicity and protection against poliovirus. Choice B is incorrect as the intramuscular vaccine is preferred for safety reasons. Choice C is incorrect because the recommendation is based on safety, not cost. Choice D is incorrect as the CDC recommendation is not solely based on immunocompromised status but rather on the overall safety and efficacy of the vaccine.

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