Nursing Elites

1. The healthcare provider should question an order for glucocorticoids in the treatment of a patient with what condition?

• A. Systemic fungal infection
• B. Diabetes Mellitus
• C. Myasthenia Gravis
• D. Glaucoma

Correct answer: A

Rationale: Glucocorticoids are contraindicated in the treatment of a patient with systemic fungal infection or in patients receiving live vaccines due to their immunosuppressive effects. Glucocorticoids can exacerbate fungal infections by suppressing the immune response. While caution is advised in patients with diabetes mellitus, myasthenia gravis, and glaucoma, the presence of a systemic fungal infection warrants questioning the use of glucocorticoids to prevent worsening of the fungal infection.

2. A child with glomerulonephritis receiving corticosteroid treatment requires dietary teaching. What instruction should the nurse provide to the parent?

• A. Increase the child's intake of potassium-rich foods.
• B. Encourage the child to eat low-calorie snacks.
• C. Offer the child a variety of fresh fruits.
• D. Restrict the child's fluid intake.

Correct answer: C

Rationale: The correct answer is to offer the child a variety of fresh fruits. Glomerulonephritis and corticosteroid use can lead to potassium depletion. Fresh fruits are a good source of potassium, which can help counteract the depletion caused by corticosteroids. Encouraging a variety of fresh fruits can provide necessary nutrients and help maintain a balanced diet for the child.

3. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

• A. Position the newborn in a semi-Fowler position.
• B. Allow the newborn to stay in the nursery for observation.
• C. Offer the newborn pacifier for comfort.
• D. Wrap the newborn in blankets and place in an incubator.

Correct answer: A

Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.

4. When teaching a parent of a toddler with congenital heart disease, which of the following instructions should the nurse include?

• A. Offer small, frequent meals.
• B. Limit the toddler's physical activity.
• C. Provide a low-sodium diet.
• D. Monitor the toddler's intake and output.

Correct answer: A

Rationale: The correct instruction for a parent of a toddler with congenital heart disease is to offer small, frequent meals. This recommendation helps reduce the cardiac workload on the child's heart and supports easier digestion and nutrient absorption, promoting the child's overall health. Limiting physical activity (choice B) may be necessary but is not the priority in this case. While offering a low-sodium diet (choice C) can be beneficial, it is not the most critical instruction. Monitoring the toddler's intake and output (choice D) is important but not as essential as providing small, frequent meals to support the child's heart health.

5. Which urinary diversion procedure is the least damaging to the body image of the adolescent?

• A. Urostomy
• B. Ileal conduit
• C. Nephrostomy
• D. Suprapubic placement

Correct answer: B

Rationale: The correct answer is B: Ileal conduit. The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. Unlike urostomy, nephrostomy, and suprapubic placement, the ileal conduit does not require an external appliance, which can be less damaging to an adolescent's body image.

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