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. What foods are appropriate for a 30-month-old toddler on a regular diet?

• A. Hamburger with bun and grapes
• B. Chicken fingers and french fries
• C. Hot dog with bun and potato chips
• D. Macaroni and cheese and Cheerios

Correct answer: D

Rationale: Macaroni and cheese and Cheerios are appropriate choices for a 30-month-old toddler on a regular diet as they provide a balance of carbohydrates and protein. Option A, hamburger with bun and grapes, may be difficult for a toddler to chew, and grapes pose a choking hazard. Option B, chicken fingers and french fries, are high in unhealthy fats and sodium. Option C, hot dog with bun and potato chips, are processed foods high in salt and unhealthy fats, not ideal for a toddler's diet.

3. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but while waiting for the administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

• A. notify the practitioner
• B. measure abdominal girth
• C. auscultate for bowel sounds
• D. take vital signs, including blood pressure

Correct answer: A

Rationale: The passage of a normal brown stool in a child with intussusception could indicate spontaneous reduction of the intussusception. This change in the patient's condition is significant, requiring prompt notification of the practitioner for further evaluation and management. While measuring abdominal girth (Choice B) is important for assessing abdominal distention, it is not the priority when a potential spontaneous reduction may have occurred. Auscultating for bowel sounds (Choice C) and taking vital signs, including blood pressure (Choice D), are routine nursing assessments but do not address the immediate need to inform the practitioner of a possible change in the patient's condition that necessitates urgent attention.

4. What should be used to feed an infant born with a unilateral cleft lip and palate?

• A. Plastic spoon
• B. Cross-cut nipple
• C. Parenteral infusion
• D. Rubber-tipped syringe

Correct answer: B

Rationale: A cross-cut nipple is the most appropriate choice for feeding an infant with a unilateral cleft lip and palate. Using a cross-cut nipple helps regulate the flow of milk, making feeding easier for the infant and reducing the risk of aspiration. Plastic spoons, parenteral infusion, and rubber-tipped syringes are not recommended for feeding infants with cleft lip and palate as they can pose risks such as choking, aspiration, or inadequate milk intake. It is essential to choose a feeding method that minimizes these risks and ensures proper nutrition for the infant.

5. What is an important nursing consideration for a child with a diagnosis of juvenile idiopathic arthritis (JIA) being treated with methotrexate?

• A. Monitor liver function tests regularly
• B. Encourage regular exercise
• C. Provide high-calorie snacks
• D. Encourage frequent handwashing

Correct answer: A

Rationale: Monitoring liver function tests regularly is crucial when a child with JIA is on methotrexate due to the potential hepatotoxicity associated with this medication. Methotrexate can lead to liver damage, hence monitoring helps in early detection and intervention. Encouraging regular exercise (Choice B) is generally good for children with JIA to maintain joint mobility and muscle strength, but it is not directly related to methotrexate therapy. Providing high-calorie snacks (Choice C) is not a priority consideration for a child on methotrexate. Encouraging frequent handwashing (Choice D) is important for infection control, but it is not specifically associated with methotrexate therapy in a child with JIA.

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