Nursing Elites

1. When explaining exercise in type 1 diabetes to the parents of a newly diagnosed child, what should the nurse emphasize?

• A. Exercise will increase blood glucose levels
• B. Exercise should be restricted
• C. Extra snacks are needed before exercise
• D. Extra insulin is required during exercise

Correct answer: C

Rationale: In children with type 1 diabetes, it is essential to emphasize the need for extra snacks before exercise to prevent hypoglycemia. Choice A is incorrect because exercise typically lowers blood glucose levels, not increases them. Choice B is inappropriate as exercise is beneficial but needs to be managed carefully. Choice D is inaccurate as extra insulin during exercise can lead to hypoglycemia.

2. A child with a diagnosis of diabetes insipidus is admitted to the hospital. What is the priority nursing intervention?

• A. Administering insulin
• B. Monitoring fluid balance
• C. Administering diuretics
• D. Monitoring vital signs

Correct answer: B

Rationale: The correct priority nursing intervention for a child diagnosed with diabetes insipidus is to monitor fluid balance. Diabetes insipidus is a condition characterized by excessive urination and thirst, which can lead to dehydration. Monitoring fluid balance is essential to prevent dehydration and ensure the child's hydration status remains stable. Administering insulin (Choice A) is not indicated in diabetes insipidus because it is a disorder of the posterior pituitary gland, not the pancreas. Administering diuretics (Choice C) would exacerbate fluid loss in a child already at risk for dehydration. Monitoring vital signs (Choice D) is important but not the priority when compared to maintaining fluid balance in a child with diabetes insipidus.

3. A child with a diagnosis of pyloric stenosis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering intravenous fluids
• B. Monitoring for signs of infection
• C. Monitoring for signs of dehydration
• D. Monitoring for signs of pain

Correct answer: C

Rationale: The correct preoperative intervention for a child with pyloric stenosis is to monitor for signs of dehydration. Pyloric stenosis involves the obstruction of the pyloric sphincter, leading to projectile vomiting, which can result in dehydration and electrolyte imbalances. Monitoring for signs of dehydration is crucial to assess the child's fluid status and prevent complications. Administering intravenous fluids, although important in managing dehydration, is not typically a preoperative intervention but rather a treatment during or after surgery. Monitoring for signs of infection and pain may also be important but are not the priority preoperative interventions in a child with pyloric stenosis.

4. When picked up by a parent or the nurse, an 8-month-old infant screams and seems to be in pain. After observing this behavior, what should the nurse discuss with the parent?

• A. Accidents and the importance of accident prevention
• B. Limiting playtime with other children in the family
• C. Any other behaviors that the parent may have noticed
• D. Food and appropriate vitamins for infants

Correct answer: C

Rationale: Discussing any other observed behaviors can help identify patterns or potential issues, which is crucial for assessing the infant's overall well-being. Option A about accidents and prevention is not pertinent to the situation described. Option B regarding playtime with other children does not address the infant's behavior and potential causes. Option D about food and vitamins is not relevant to the presented scenario and the observed behavior of the infant.

5. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?

• A. Deep-breathing exercises
• B. Upright positioning
• C. Coughing
• D. Chest percussion

Correct answer: B

Rationale: Upright positioning is the most appropriate intervention to promote maximum chest expansion in a child with Duchenne muscular dystrophy. By keeping the child in an upright position, lung expansion is maximized, which improves breathing efficiency. Deep-breathing exercises may help with overall lung function but do not directly promote chest expansion. Coughing and chest percussion are more related to airway clearance and do not specifically address maximizing chest expansion.

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