Nursing Elites

1. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?

• A. Instructing the parents to report adverse reactions to the growth hormone treatment
• B. Teaching the parents how to administer desmopressin acetate
• C. Informing the parents that treatment continues during puberty
• D. Educating the parents to report signs of acute adrenal crisis

Correct answer: B

Rationale: For a child with a disorder of the posterior pituitary gland, desmopressin acetate is a medication commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents on how to administer desmopressin acetate correctly is essential for the child's care. Choice A is incorrect because growth hormone treatment is not typically used for posterior pituitary disorders. Choice C is incorrect as treatment for this condition usually continues beyond puberty. Choice D is incorrect as acute adrenal crisis is not directly related to a disorder of the posterior pituitary gland.

2. The parents of a child with asthma ask the nurse how they can help their child prevent asthma attacks. What should the nurse advise?

• A. Avoid exposure to allergens
• B. Encourage regular exercise
• C. Provide a high-protein diet
• D. Increase fluid intake

Correct answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are often triggered by allergens such as dust mites, pollen, pet dander, and mold. By minimizing the child's exposure to these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise is beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general well-being but do not specifically address asthma prevention.

3. A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is essential for managing type 1 diabetes mellitus. Hypoglycemia, which occurs when blood glucose levels drop too low, can be dangerous and requires immediate intervention to prevent severe complications. Monitoring blood glucose levels more frequently than once a day, following a strict meal plan, and administering insulin only when blood glucose is high are important aspects of diabetes management but recognizing signs of hypoglycemia is crucial as it enables prompt action to prevent adverse outcomes.

4. Which of the following techniques represents the most appropriate method of opening the airway of an infant with no suspected neck injury?

• A. lift up the chin and hyperextend the neck
• B. tilt the head back without hyperextending the neck
• C. gently lift the chin while maintaining slight flexion of the neck
• D. perform the technique as you would for an older child or adult

Correct answer: B

Rationale: The correct technique for opening the airway of an infant with no suspected neck injury is to tilt the head back without hyperextending the neck. This method helps to keep the airway open without risking injury to the infant's delicate neck structures. Choice A, lifting up the chin and hyperextending the neck, can potentially harm the infant's neck. Choice C, gently lifting the chin while maintaining slight flexion of the neck, is not as effective as tilting the head back. Choice D is incorrect as infants require a different approach compared to older children or adults due to their anatomical differences.

5. On the third day of hospitalization, the nurse observes that a 2-year-old toddler who had been screaming and crying inconsolably begins to regress and is now lying quietly in the crib with a blanket. What stage of separation anxiety has developed?

• A. Denial
• B. Despair
• C. Mistrust
• D. Rejection

Correct answer: B

Rationale: The correct answer is B: Despair. In separation anxiety, the stage of despair is characterized by regression and withdrawal after an initial period of protest. The child may become quiet and appear to accept the separation, but this is actually a sign of deeper distress. Choice A, Denial, is incorrect as it refers to refusing to believe or accept the reality of the separation. Choice C, Mistrust, is incorrect as it pertains to a lack of trust in others, not a stage of separation anxiety. Choice D, Rejection, is incorrect as it involves pushing others away and not related to the described behavior of the toddler in the scenario.

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