Nursing Elites

1. The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with the disorder?

• A. The parents report that their child had 'a cold or flu' recently.
• B. Blood pressure is decreased when checking vital signs.
• C. The parents report that their son 'can’t drink enough water.'
• D. Auscultation reveals Kussmaul breathing.

Correct answer: C

Rationale: The correct answer is C. Excessive thirst (polydipsia) is a common symptom of type 2 diabetes mellitus, indicating high blood glucose levels. This symptom occurs due to the body trying to get rid of excess glucose through urine, leading to dehydration and increased thirst. Choices A, B, and D are incorrect. Choice A is more indicative of a recent viral illness rather than a symptom of diabetes. Choice B, decreased blood pressure, is not typically associated with type 2 diabetes; in fact, diabetes can often lead to hypertension. Choice D, Kussmaul breathing, is more characteristic of diabetic ketoacidosis, which is more common in type 1 diabetes rather than type 2 diabetes.

2. A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?

• A. Avoid triggers that cause flare-ups
• B. Apply topical corticosteroids as prescribed
• C. Use a soft toothbrush for oral care
• D. Avoid contact with sick individuals

Correct answer: B

Rationale: The correct answer is to 'Apply topical corticosteroids as prescribed.' Atopic dermatitis is a condition characterized by inflammation and itchiness of the skin. Topical corticosteroids are commonly used to reduce inflammation and relieve symptoms in atopic dermatitis. Teaching the caregiver to apply the medication as prescribed by the healthcare provider is crucial for managing the child's condition effectively. Choices A, C, and D are not the priority discharge teaching for atopic dermatitis. While avoiding triggers that cause flare-ups and contact with sick individuals can be beneficial, the immediate focus should be on proper medication administration to address the underlying inflammation and symptoms of atopic dermatitis.

3. The nurse is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?

• A. After a decade of escalation, the percentage of children living in low-income families has been on the decline since 2000.
• B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
• C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but a large increase is occurring in African American females.
• D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.

Correct answer: B

Rationale: Choice B is the correct answer because it accurately states that White, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This reflects a disparity in health outcomes among different racial groups. Choices A, C, and D are incorrect. Choice A is unrelated to the impact of common barriers to health care on families. Choice C talks about overweight children but does not address access to health care. Choice D discusses the impact of the overall health care plan on working families but does not specifically address the disparity in health status among different racial groups.

4. A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?

• A. suction the oropharynx
• B. insert a nasopharyngeal airway
• C. initiate positive pressure ventilations
• D. place the patient in the recovery position

Correct answer: A

Rationale: In this scenario, the 4-year-old is presenting with signs of airway compromise due to the fall. After performing a jaw-thrust maneuver to open the airway while stabilizing the head to prevent further injury, the next step should be to suction the oropharynx. Suctioning helps to clear any blood or secretions from the mouth and throat, ensuring a clear airway for proper breathing. Inserting a nasopharyngeal airway or initiating positive pressure ventilations would be premature without first ensuring the airway is clear. Placing the patient in the recovery position is not indicated at this point as the focus should be on managing the airway.

5. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?

• A. Child is in the concrete operational stage of cognition.
• B. Child’s dependence on peer influence is increasing.
• C. Child will welcome opportunities for participation in self-care.
• D. Child is exploring their sense of self-identity.

Correct answer: C

Rationale: The correct answer is C. At the age of 8, children are typically eager to take on responsibilities and participate in self-care activities. This is a crucial developmental characteristic to consider when educating a child about managing a chronic condition like type 1 diabetes. Choice A is incorrect as children at this age are usually in the concrete operational stage, not abstract level, of cognition. Choice B is incorrect because while peer influence is important, it does not reach its peak at this age. Choice D is incorrect as exploring self-identity is more characteristic of adolescence, not 8-year-old children.

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