Nursing Elites

1. In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?

• A. Deficient fluid volume related to dehydration
• B. Excess fluid volume related to edema
• C. Deficient knowledge related to fluid intake regimen
• D. Imbalanced nutrition, more than body requirements related to excess weight

Correct answer: A

Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.

2. A nurse is providing care to a child diagnosed with sickle cell anemia. What is the priority nursing intervention?

• A. Administering pain medication
• B. Ensuring adequate hydration
• C. Providing nutritional support
• D. Monitoring vital signs

Correct answer: A

Rationale: In sickle cell anemia, pain management is a priority due to vaso-occlusive crises that cause severe pain. Administering pain medication helps alleviate discomfort and improve the child's quality of life. Ensuring adequate hydration, although important, is secondary to addressing the immediate pain issue. Providing nutritional support is beneficial for overall health but does not address the acute pain experienced. Monitoring vital signs is essential but not the immediate priority when managing pain in sickle cell anemia.

3. Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

• A. pulmonary infection
• B. right-to-left shunt of blood
• C. decreased workload on the left side of the heart
• D. increased pulmonary vascular congestion

Correct answer: D

Rationale: Surgical repair of patent ductus arteriosus (PDA) aims to prevent increased pulmonary vascular congestion, which can lead to congestive heart failure and respiratory distress. Choice A, pulmonary infection, is not a direct complication of PDA but rather a result of other factors. Choice B, right-to-left shunt of blood, is a characteristic of a different heart condition (e.g., Tetralogy of Fallot) and not specifically associated with PDA. Choice C, decreased workload on the left side of the heart, is not a typical complication of PDA but rather a consequence of left-to-right shunting that can cause volume overload in the pulmonary circulation.

4. What is the primary treatment for minimal change nephrotic syndrome?

• A. corticosteroids
• B. antihypertensive agents
• C. long-term diuretics
• D. increased fluids to promote diuresis

Correct answer: A

Rationale: Corticosteroids are the mainstay of treatment for minimal change nephrotic syndrome due to their immunosuppressive effects, which help reduce proteinuria and control the disease progression. Antihypertensive agents are not the primary treatment for this condition and are typically used to manage hypertension that may result from nephrotic syndrome. Long-term diuretics are not indicated in the treatment of minimal change nephrotic syndrome as they do not address the underlying cause. Increasing fluids to promote diuresis is not a recommended treatment for minimal change nephrotic syndrome, as it can exacerbate edema and fluid overload in these patients.

5. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential for managing type 1 diabetes mellitus. This timing helps in assessing the effectiveness of insulin therapy, making adjustments to insulin doses, and preventing hyperglycemia and hypoglycemia. Option B is incorrect because it focuses on the method of obtaining blood samples rather than the timing of monitoring. Option C is incorrect as urine test strips are not recommended for accurate blood glucose monitoring in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when teaching about blood glucose monitoring.

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