Nursing Elites

1. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

2. A young mother asks if her 9-month-old can begin drinking cow’s milk instead of formula. You explain that:

• A. Cow’s milk is easier to digest than formula
• B. Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year
• C. As long as whole milk is given and not skim milk, it is okay
• D. Cow’s milk will decrease the chance of iron deficiency anemia

Correct answer: B

Rationale: Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year. Cow’s milk is not suitable for infants under 1 year of age as it lacks essential nutrients like iron and can lead to iron deficiency. Therefore, it is important to continue with breast milk or formula to ensure the baby's nutritional needs are met. Choice A is incorrect as cow’s milk is not easier to digest than formula for infants. Choice C is incorrect as the type of milk, whether whole or skim, is not the primary concern at this age. Choice D is incorrect as cow’s milk can actually increase the risk of iron deficiency anemia in infants.

3. The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?

• A. Age of the child
• B. Gender of the child
• C. Family characteristics
• D. Ongoing family conflict

Correct answer: D

Rationale: The level of ongoing family conflict is the most significant factor influencing the positive or negative outcomes for children during and after a divorce

4. The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)

• A. Hyponatremia
• B. Hyperkalemia
• C. All are applicable
• D. Elevated blood urea nitrogen level

Correct answer: C

Rationale: In acute renal failure, laboratory findings typically include hyperkalemia, hyponatremia, and elevated blood urea nitrogen (BUN) levels due to the kidneys' inability to excrete waste and balance electrolytes. Metabolic alkalosis is less common, with metabolic acidosis being more typical.

5. The nurse is presenting a staff development program about understanding culture in the healthcare encounter. Which components should the nurse include in the program? (Select all that apply.)

• A. Cultural humility
• B. All are applicable
• C. Cultural sensitivity
• D. Cultural competency

Correct answer: B

Rationale: Cultural humility, sensitivity, and competency are key components in providing culturally competent care in healthcare encounters.

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