Nursing Elites

1. The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.)

• A. All below
• B. Lethargy
• C. Oliguria
• D. Intense thirst

Correct answer: A

Rationale: Hypernatremia typically presents with lethargy, oliguria, and intense thirst due to the body's attempt to conserve water. Apathy can also occur, but lethargy and thirst are more consistent indicators.

2. The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?

• A. My child needs to stay home from school for at least 1 more month.
• B. I should not add additional salt to any of my child's meals.
• C. My child will not be able to participate in contact sports while receiving corticosteroid therapy.
• D. I should measure my child's urine after each void and report the 24-hour amount to the healthcare provider.

Correct answer: B

Rationale: Avoiding additional salt is crucial to help manage edema in children with MCNS. While monitoring urine output is important, the other statements either misinterpret the need for prolonged school absence or misunderstand the risk associated with contact sports during steroid therapy.

3. What intervention is contraindicated in a suspected case of appendicitis?

• A. Enemas
• B. Palpating the abdomen
• C. Administration of antibiotics
• D. Administration of antipyretics for fever

Correct answer: A

Rationale: Enemas are contraindicated in cases of suspected appendicitis because they can increase the risk of perforation. The pressure from the enema can exacerbate inflammation and potentially lead to the rupture of the appendix. Palpating the abdomen gently is essential for diagnosing appendicitis, as it helps identify the characteristic signs like rebound tenderness. Antibiotics are commonly used to treat the infection associated with appendicitis, and antipyretics are administered to manage fever, which is a common symptom of the condition. Therefore, enemas are the intervention to avoid in suspected appendicitis cases.

4. What is the primary treatment for Kawasaki disease?

• A. Corticosteroids
• B. Intravenous immunoglobulin
• C. Antibiotics
• D. Antivirals

Correct answer: B

Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.

5. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?

• A. Steatorrhea
• B. Clay-colored
• C. Currant jelly-like
• D. Loose stools with undigested food

Correct answer: C

Rationale: Corrected Rationale: Currant jelly-like stools, which contain blood and mucus, are characteristic of Meckel diverticulum. This symptom occurs due to the bleeding from the ectopic gastric mucosa present in the diverticulum. Steatorrhea (choice A) is not typically associated with Meckel diverticulum. Clay-colored stools (choice B) are seen in conditions affecting the biliary system. Loose stools with undigested food (choice D) may indicate malabsorption issues, but it is not specifically linked to Meckel diverticulum.

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