Nursing Elites

1. The family of a newly admitted child with cystic fibrosis is educated by the nurse that the treatment will be centered on what therapy?

• A. Chest physiotherapy
• B. Mucus-drying agents
• C. Prevention of diarrhea
• D. Insulin therapy

Correct answer: A

Rationale: The correct answer is A: Chest physiotherapy. In cystic fibrosis, chest physiotherapy and aerosol medications are fundamental components of treatment to help clear mucus from the lungs, reduce the risk of infections, and improve breathing. Mucus-drying agents (Choice B) are not typically used in the treatment of cystic fibrosis. Prevention of diarrhea (Choice C) is not a primary focus in the treatment of cystic fibrosis. Insulin therapy (Choice D) is not relevant to cystic fibrosis, as it is a treatment for diabetes.

2. Ten hours following thrombolysis for an ST elevation myocardial infarction (STEMI), a client is receiving a lidocaine infusion for isolated runs of ventricular tachycardia. Which finding should the nurse document in the EMR as a therapeutic response to the lidocaine infusion?

• A. Stabilization of BP ranges
• B. Cessation of chest pain
• C. Reduced heart rate
• D. Decreased frequency of episodes of VT

Correct answer: D

Rationale: The correct answer is D. Decreased frequency of ventricular tachycardia (VT) episodes indicates that the lidocaine infusion is effectively managing the ventricular tachycardia. Stabilization of BP ranges (choice A) may not directly correlate with the therapeutic response to lidocaine for VT. Cessation of chest pain (choice B) may indicate pain relief but does not specifically address the effectiveness of lidocaine for VT. Reduced heart rate (choice C) is not a direct indicator of the response to lidocaine for managing VT.

3. How is gastroesophageal reflux (GER) typically treated in infants?

• A. By placing the infant NPO
• B. By thickening the formula or breast milk with cereal
• C. By placing the infant to sleep on the side
• D. By switching the infant to cow's milk

Correct answer: B

Rationale: Gastroesophageal reflux (GER) in infants is typically treated by thickening the formula or breast milk with cereal. This helps reduce reflux episodes by making the feedings heavier and less likely to come back up. Placing the infant NPO (nothing by mouth) is not the typical treatment for GER as infants need proper nutrition for growth. Placing the infant to sleep on the side is not recommended due to the risk of SIDS; infants should be placed on their back to sleep. Switching the infant to cow's milk is also not a treatment for GER, as cow's milk can be harder to digest and may exacerbate symptoms.

4. A client with diabetes mellitus presents with confusion and diaphoresis. What is the priority nursing action?

• A. Check the blood glucose level
• B. Administer insulin immediately
• C. Offer a high-protein snack
• D. Place the client in a supine position

Correct answer: A

Rationale: The correct answer is to check the blood glucose level. In a client with diabetes mellitus presenting with confusion and diaphoresis, it is important to assess the blood glucose level first to determine if the symptoms are due to hypoglycemia. Administering insulin immediately (Choice B) without knowing the blood glucose level can worsen the condition if the client is hypoglycemic. Offering a high-protein snack (Choice C) is not appropriate as the severity of hypoglycemia is unknown, and placing the client in a supine position (Choice D) is not the priority action for these symptoms.

5. A client with ulcerative colitis is experiencing frequent diarrhea. What is the priority nursing diagnosis?

• A. Risk for impaired skin integrity
• B. Fluid volume deficit
• C. Imbalanced nutrition: less than body requirements
• D. Activity intolerance

Correct answer: B

Rationale: The correct answer is B: Fluid volume deficit. In a client with ulcerative colitis experiencing frequent diarrhea, the priority nursing diagnosis is addressing the potential fluid volume deficit due to significant fluid loss. Maintaining adequate hydration is crucial to prevent complications associated with dehydration. While choices A, C, and D can also be concerns for a client with ulcerative colitis, addressing fluid volume deficit takes precedence as it directly impacts the client's physiological stability and can lead to serious complications if not managed promptly.

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