Nursing Elites

1. The healthcare provider is providing dietary teaching to the parent of a school-age child who has celiac disease. The healthcare provider should recommend that the parent offer which of the following foods to the child?

• A. Wheat bread
• B. Vanilla malt
• C. Barley soup
• D. Rice pudding

Correct answer: D

Rationale: Celiac disease requires a lifelong gluten-free diet. Foods containing gluten such as wheat, barley, and rye should be avoided. Rice pudding is a safe option as it does not contain gluten, making it a suitable choice for a child with celiac disease.

2. Marge is a 2-year-old girl who does not sit and eat at mealtimes but rather brings food to many rooms, eats a few bites, and drops it. Her parents report that she is a 'fussy eater.' Marge is significantly below weight for her age. She does not have any oral motor structure abnormalities, but eats only certain foods with the same texture. Which intervention strategy would be best to address the environmental context?

• A. Prolong mealtimes and eliminate all snacks
• B. Provide high-calorie snacks and meals at the table throughout the day
• C. Allow Marge to eat whenever and wherever she wants in the house
• D. Require Marge to eat everything on her plate and at snack

Correct answer: B

Rationale: In the case of Marge, who exhibits selective eating habits and struggles with weight gain, providing high-calorie snacks and meals at the table throughout the day can be an effective intervention. This strategy can help increase her food intake in a structured environment, promoting healthier eating habits and potentially addressing her below-average weight status. Choice A, prolonging mealtimes and eliminating all snacks, may not be the best approach as it could lead to more food refusal and stress during meals. Choice C, allowing Marge to eat whenever and wherever she wants in the house, may further enable her selective eating behavior and hinder progress. Choice D, requiring Marge to eat everything on her plate and at snack, can create a negative mealtime environment and may not address the underlying causes of her eating habits. Therefore, providing high-calorie snacks and meals at designated times offers a balanced approach to support Marge's nutritional needs and overall well-being.

3. A parent of a child with cerebral palsy is being taught about home care by a healthcare provider. Which statement by the parent indicates an understanding of the teaching?

• A. I will perform range-of-motion exercises twice a day.
• B. I will apply a heating pad on my child's legs to reduce spasms.
• C. I will allow my child to rest in a recliner for 1 hour each day.
• D. I will use wrist splints to maintain alignment.

Correct answer: D

Rationale: Using wrist splints can help maintain alignment and prevent contractures in a child with cerebral palsy. This intervention is crucial in managing the condition and supporting the child's mobility and function.

4. What is the goal of pharmacologic therapy in the treatment of Parkinson�s disease?

• A. To increase the amount of acetylcholine at the pre-synaptic neurons
• B. To reduce the amount of dopamine available in the substantia nigra
• C. To balance cholinergic and dopaminergic activity in the brain
• D. To block dopamine receptors in pre-synaptic and post-synaptic neurons

Correct answer: C

Rationale: Parkinson�s disease results from a decrease in dopaminergic (inhibitory) activity, leaving an imbalance with too much cholinergic (excitatory) activity. With an increase in dopamine, the neurotransmitter activity becomes more balanced, and symptoms are controlled.

5. The nurse plans to closely monitor for which clinical manifestation after administering furosemide (Lasix)?

• A. Decrease pulse
• B. Decrease temperature
• C. Decrease BP
• D. Decrease respiratory rate.

Correct answer: C

Rationale: High-ceiling diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased BP. When BP drops, the pulse will probably increase rather than decrease.

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