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 nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit for it to be most productive?

• A. When the husband is out of the home.
• B. At a time when the mother is feeding the infant.
• C. At a time that is convenient for the family.
• D. When the nurse can spend time with the family.

Correct answer: C

Rationale: Scheduling the visit at a time that is convenient for the family is the most appropriate choice. This ensures that the family is receptive and available, making the visit more productive. Choice A is incorrect because the presence of the husband may be important for support and decision-making. Choice B focuses solely on the mother and the infant's feeding time, which may not align with the family's overall availability. Choice D is incorrect as it emphasizes the nurse's convenience rather than the family's, which may not lead to an effective visit.

3. A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is essential for managing type 1 diabetes mellitus. Hypoglycemia, which occurs when blood glucose levels drop too low, can be dangerous and requires immediate intervention to prevent severe complications. Monitoring blood glucose levels more frequently than once a day, following a strict meal plan, and administering insulin only when blood glucose is high are important aspects of diabetes management but recognizing signs of hypoglycemia is crucial as it enables prompt action to prevent adverse outcomes.

4. The healthcare professional is developing a teaching plan for a child who is to have their cast removed. What instruction would the professional most likely include?

• A. Applying petroleum jelly to the dry skin.
• B. Rubbing the skin vigorously to remove the dead skin.
• C. Soaking the area in warm water every day.
• D. Washing the skin with diluted peroxide and water.

Correct answer: C

Rationale: Soaking the area in warm water is the most appropriate instruction for a child who is having their cast removed. This method helps to gently remove dead skin without causing irritation. Applying petroleum jelly to dry skin (Choice A) is not recommended as it may not effectively aid in the removal of dead skin. Rubbing the skin vigorously (Choice B) can lead to skin irritation and should be avoided. Washing the skin with diluted peroxide and water (Choice D) may be too harsh, causing unnecessary irritation to the skin post-cast removal.

5. Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse’s knowledge of congenital heart defects, this system in clinical practice is

• A. helpful because it explains the hemodynamics involved
• B. helpful because children with cyanotic defects are easily identified
• C. problematic because cyanosis is rarely present in children
• D. problematic because children with acyanotic heart defects may develop cyanosis

Correct answer: D

Rationale: The classification is problematic because children with acyanotic heart defects may develop cyanosis, complicating the differentiation between acyanotic and cyanotic defects. Choice A is incorrect because the system is not solely based on explaining hemodynamics. Choice B is incorrect because the classification is not based on the ease of identifying children with cyanotic defects. Choice C is incorrect because cyanosis can indeed be present in children with congenital heart defects, especially acyanotic defects that may lead to cyanosis under certain circumstances.

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