Nursing Elites

1. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?

• A. Administering a cough suppressant
• B. Inserting a Foley catheter
• C. Administering an anti-diarrheal
• D. Monitoring urinary output

Correct answer: B

Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.

2. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

• A. Massive proteinuria, hypoalbuminemia, and edema
• B. Hematuria, bacteriuria, and weight gain
• C. Decreased urine specific gravity and increased urinary output
• D. Gross hematuria, albuminuria, and fever

Correct answer: A

Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.

3. What type of mode best describes Kasey's approach when meeting with the principal to change the cafeteria to better accommodate her client with difficulty eating in a noisy and distracting environment?

• A. Collaborating
• B. Instructing
• C. Advocating
• D. Encouraging

Correct answer: C

Rationale: Advocating best describes Kasey's approach in this scenario. Advocating involves presenting stories, research, and ideas to support and champion for a specific cause or individual, in this case, advocating for changes to better meet the child's needs in the cafeteria. Collaborating involves working together with others towards a common goal, instructing involves providing guidance or directions, and encouraging involves giving support or motivation, none of which fully capture Kasey's proactive and supportive advocacy actions in this context.

4. When conducting an initial feeding evaluation, the therapist asks the caregiver to bring the utensils, food, and high chair that they typically use. Which statement best reflects the therapist's reasoning for this?

• A. Using the child's actual materials will give the therapist an accurate picture
• B. The therapist wants to be sensitive to the child's culture
• C. The center has limited funds for food and materials
• D. The therapist would like to know if the caregiver can follow directions

Correct answer: A

Rationale: By having the caregiver bring the child's familiar utensils, food, and high chair, the therapist can observe the child's typical eating behaviors and challenges accurately. This provides valuable insights that help in tailoring appropriate interventions to address feeding issues effectively.

5. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

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