Nursing Elites

1. During a check-up for a 5-year-old child with eczema before school starts, what will the nurse do?

• A. Change the bandage on a cut on the child’s hand.
• B. Assess the compliance with treatment regimens.
• C. Discuss systemic corticosteroid therapy.
• D. Assess the child’s fluid volume.

Correct answer: B

Rationale: Assessing compliance with treatment regimens is crucial in managing eczema effectively and preventing flare-ups. This involves ensuring that the child is following the prescribed treatment plan, which may include medication application, skincare routines, and lifestyle modifications. Changing a bandage on a cut would not be a routine part of an eczema check-up unless there was a specific wound related to eczema. Discussing systemic corticosteroid therapy may be part of the management plan for severe eczema cases but would not be the primary focus during a routine check-up. Assessing the child’s fluid volume, while important in general health assessments, is not directly related to managing eczema specifically.

2. 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.

3. The nurse is counseling a young couple who in 2 months are having their third baby. The nurse uses Von Bertalanffy's general system theory applied to families to analyze the family structure. Which best describes the main emphasis of this theory and its application to family dynamics?

• A. It emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components.
• B. It emphasizes the social system of the family, such as the organization or structure of the family and how the structure relates to its function.
• C. It emphasizes the developmental stages that all families go through, beginning with marriage; the longitudinal career of the family is also known as the family life cycle.
• D. It addresses how families respond to stress and how the family copes with stress as a group and how each individual member copes.

Correct answer: A

Rationale: Von Bertalanffy's general system theory applied to families emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components. This theory focuses on viewing the family as a dynamic system where each member's actions and behaviors impact the whole family unit. Choice B is incorrect as it focuses solely on the social system of the family, while Von Bertalanffy's theory looks at the family as a whole system. Choice C is incorrect as it discusses family developmental stages, which is not the main emphasis of Von Bertalanffy's theory. Choice D is also incorrect as it only addresses how families respond to stress, which is a narrower focus compared to the broader system view of Von Bertalanffy's theory.

4. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

5. 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.

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