Nursing Elites

1. Which level nursery classifications are housed in institutions that can provide on-site surgical repair of serious congenital or acquired malformations?

• A. Level III
• B. Level I
• C. Level IV
• D. Level II

Correct answer: C

Rationale: The correct answer is C: Level IV. Level IV nurseries are equipped to provide the highest level of care, including complex surgical interventions for serious congenital or acquired malformations. These nurseries have the necessary resources and expertise to manage critical cases effectively. Choice A: Level III nurseries provide advanced care for moderately ill newborns but may not have the capacity for on-site surgical repair of serious malformations. Choice B: Level I nurseries offer basic care for healthy newborns and those with minor issues, lacking the resources for surgical interventions. Choice D: Level II nurseries can manage moderately ill newborns but may not have the capability for complex surgical interventions like Level IV nurseries.

2. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?

• A. Administering a cough suppressant
• B. Inserting a Foley catheter
• C. Administering an anti-diarrheal
• D. Monitoring urinary output

Correct answer: B

Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.

3. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

4. 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.

5. What is an initial sign of nephrosis that the nurse might note in a child?

• A. Raspberry-like rash
• B. Periorbital edema
• C. Temperature elevation
• D. Abdominal pain

Correct answer: B

Rationale: In nephrotic syndrome, edema is a common symptom that is generalized and not easily noticeable, even by parents. However, an early sign that can be assessed by the nurse is periorbital edema, which refers to swelling around the eyes. This can be an initial indicator of nephrosis and may prompt further evaluation and intervention.

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