Nursing Elites

1. Use the scenario to answer questions 13-18. A patient has come to the OPD with complaints of anaesthesia and paresthesia of the lower limbs. After laboratory investigations, the doctor has diagnosed the patient with Diabetes Mellitus but failed to specify whether it is type 1 or type 2. Onset of Type 1 diabetes is characterized by:

• A. Occurs after pubertal onset in the majority of cases
• B. Occurs when parents are poor
• C. Occurs at an early age
• D. Occurs after childbirth

Correct answer: A

Rationale: Type 1 diabetes typically occurs after pubertal onset. This form of diabetes is most commonly diagnosed in individuals under the age of 30, with a peak incidence in the mid-teens to early 20s. Puberty is a period of hormonal changes and growth, which can trigger the onset of type 1 diabetes due to the stress it places on the body's insulin-producing cells.

2. The caregiver is teaching a new mother about infant safety. Which statement indicates that further teaching is needed?

• A. I will place my baby on their back to sleep.
• B. I will keep soft toys and pillows out of the crib.
• C. I will use a car seat for every car ride.
• D. I will allow my baby to sleep in my bed.

Correct answer: D

Rationale: Allowing a baby to sleep in an adult bed increases the risk of suffocation and Sudden Infant Death Syndrome (SIDS). It is safer for infants to sleep on a firm, flat surface in their own crib or bassinet to reduce the risk of accidental suffocation or strangulation. Therefore, the caregiver should be advised against co-sleeping with the infant to ensure the baby's safety.

3. The nurse is assessing a postpartum client's fundus. Where should the nurse expect to find the fundus 24 hours after delivery?

• A. At the level of the umbilicus
• B. 1 cm above the symphysis pubis
• C. At the level of the xiphoid process
• D. 2 cm below the umbilicus

Correct answer: A

Rationale: After delivery, the fundus is expected to be at the level of the umbilicus 24 hours postpartum. This position indicates that the uterus is involuting properly. Assessing the fundal height helps monitor the progress of uterine involution and can identify any potential complications like postpartum hemorrhage.

4. The healthcare provider is assessing a postpartum client who is 1 day post-delivery. Which finding would require immediate intervention?

• A. Lochia rubra with a few small clots
• B. Fundus firm and midline
• C. Temperature of 100.4°F (38°C)
• D. Saturated perineal pad in 15 minutes

Correct answer: D

Rationale: A saturated perineal pad in 15 minutes indicates excessive bleeding, known as postpartum hemorrhage, which is a critical condition requiring immediate intervention to prevent further complications like hypovolemic shock. Monitoring and managing postpartum bleeding are crucial in the early postpartum period to ensure the client's safety and well-being. The other options are normal postpartum findings: lochia rubra with a few small clots is expected in the early postpartum period, a firm and midline fundus indicates proper uterine contraction, and a temperature of 100.4°F (38°C) is within the normal range for the postpartum period.

5. Atta, who weighs 20kg, has been prescribed amoxicillin 500 mg b.i.d. The drug information indicates a daily dose of amoxicillin at 50 mg/kg/day in two divided doses. What is the safest dose in milligrams for this child?

• A. 1000 mg
• B. 750 mg
• C. 500 mg
• D. 250 mg

Correct answer: A

Rationale: To calculate the safest dose of amoxicillin for Atta, we multiply the weight (20kg) by the daily dose (50 mg/kg/day) which equals 1000 mg/day. Since the dose is to be given in two divided doses, the safest dose for each administration would be 500 mg. Therefore, the correct answer is 1000 mg, as it aligns with the prescribed dose for this child based on weight and dosing guidelines. Choice B, 750 mg, is incorrect as it does not match the calculated daily dose. Choice C, 500 mg, is incorrect as it represents the safest dose for each administration, not the total daily dose. Choice D, 250 mg, is incorrect as it is below the calculated daily dose required for the child.

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