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. A child with a diagnosis of nephrotic syndrome is under the care of a nurse. What is the priority nursing intervention?

• A. Administering diuretics
• B. Monitoring urine output
• C. Administering corticosteroids
• D. Restricting fluid intake

Correct answer: B

Rationale: The priority nursing intervention when caring for a child with nephrotic syndrome is to monitor urine output. This is essential to assess kidney function and evaluate the effectiveness of treatment. Administering diuretics (Choice A) may be a part of the treatment plan but should not be the priority over monitoring urine output. Administering corticosteroids (Choice C) is a common treatment for nephrotic syndrome, but monitoring urine output takes precedence. Restricting fluid intake (Choice D) may be necessary in some cases, but it is not the priority intervention compared to monitoring urine output.

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 crucial for managing type 1 diabetes mellitus and preventing complications.

4. Which observation made of the exposed abdomen is most indicative of pyloric stenosis?

• A. abdominal rigidity
• B. substernal retraction
• C. palpable olive-like mass
• D. marked distention of lower abdomen

Correct answer: C

Rationale: The correct answer is C: palpable olive-like mass. In pyloric stenosis, a palpable olive-like mass can often be felt in the abdomen due to the hypertrophied pyloric muscle. This mass is a key characteristic finding in infants with pyloric stenosis. Choice A, abdominal rigidity, is more commonly associated with conditions like peritonitis. Choice B, substernal retraction, is not typically seen in pyloric stenosis but can be a sign of respiratory distress. Choice D, marked distention of the lower abdomen, is not specific to pyloric stenosis and can be present in various abdominal conditions.

5. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?

• A. Encourage participation in physical activity
• B. Provide a high-calorie diet
• C. Provide a low-sodium diet
• D. Administer intravenous fluids

Correct answer: A

Rationale: Encouraging regular physical activity is crucial in managing symptoms and improving joint function in juvenile idiopathic arthritis. It helps maintain joint mobility, muscle strength, and overall well-being. Providing a high-calorie diet (Choice B) is not typically recommended unless there are specific nutritional concerns or growth issues. A low-sodium diet (Choice C) may be beneficial in conditions like hypertension, but it is not a primary focus for JIA management. Administering intravenous fluids (Choice D) is not a routine part of managing JIA unless specifically indicated for hydration or medication administration.

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