Nursing Elites

1. What should be included in the teaching plan for parents of an infant diagnosed with phenylketonuria (PKU)?

• A. Mental retardation occurs if PKU is untreated.
• B. Testing for PKU is done immediately after birth.
• C. Treatment for PKU includes lifelong dietary management.
• D. PKU is transmitted by an autosomal recessive gene.

Correct answer: A

Rationale: The correct answer is A: 'Mental retardation occurs if PKU is untreated.' Phenylketonuria (PKU) is a metabolic disorder that, if left untreated with dietary management, can lead to severe mental retardation due to the accumulation of phenylalanine. It is crucial for parents to understand the potential consequences of untreated PKU to emphasize the importance of early and consistent treatment. Choice B is incorrect because testing for PKU is typically done through newborn screening shortly after birth, not immediately. Choice C is incorrect as treatment for PKU primarily involves strict dietary management that restricts phenylalanine intake, not lifelong medications. Choice D is incorrect as PKU is inherited in an autosomal recessive pattern, meaning that both parents must pass on a mutated gene for the disorder to manifest.

2. What treatment should the nurse suggest to an adolescent with type 1 diabetes if an insulin reaction is experienced while at a basketball game?

• A. Call your parents immediately.
• B. Buy a soda and hamburger to eat.
• C. Administer insulin as soon as possible.
• D. Leave the arena and rest until the symptoms subside.

Correct answer: B

Rationale: When an adolescent with type 1 diabetes experiences an insulin reaction, it is essential to quickly raise their blood sugar levels. Buying a soda and a hamburger to eat is the best choice in this situation as it provides a fast-acting source of sugar to counteract hypoglycemia. Calling parents immediately may cause a delay in receiving appropriate treatment. Administering insulin would further lower blood sugar levels, worsening the situation. Leaving the arena and resting would not address the immediate need to raise blood sugar levels.

3. An infant who had cardiac surgery for a congenital defect is to be discharged. What should the nurse emphasize to the parents regarding administering the prescribed antibiotic?

• A. Give the antibiotic between feedings.
• B. Ensure that the antibiotic is administered as prescribed.
• C. Shake the bottle thoroughly before giving the antibiotic.
• D. Keep the antibiotic in the refrigerator after the bottle has been opened.

Correct answer: B

Rationale: The correct answer is B: 'Ensure that the antibiotic is administered as prescribed.' It is crucial for the parents to follow the prescribed antibiotic regimen to prevent infections and promote proper healing following cardiac surgery. Option A is incorrect because the timing of antibiotic administration may vary depending on the specific medication and instructions. Option C is not necessary and could potentially affect the antibiotic's effectiveness. Option D is not relevant to the administration of the antibiotic and does not ensure proper usage.

4. Why might a healthcare provider question a health care provider's order for a tap water enema for a 6-month-old infant with suspected Hirschsprung disease?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas are unlikely to lead to loss of necessary nutrients. Choice C is incorrect as it does not directly relate to the physiological risk of tap water enemas. Choice D is incorrect as shock from a sudden drop in temperature is not a common concern with tap water enemas.

5. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

• A. Skeletal traction
• B. Physical therapy
• C. Orthotics
• D. Occupational therapy

Correct answer: A

Rationale: In caring for a child with cerebral palsy, skeletal traction is least likely to be a part of the treatment plan. Cerebral palsy is a neurological disorder affecting movement and muscle coordination, and skeletal traction, which involves applying a pulling force on a bone to correct alignment, is not a common intervention for this condition. Physical therapy, orthotics, and occupational therapy are more commonly used in the management of cerebral palsy. Physical therapy helps improve mobility and strength, orthotics assist in supporting and aligning the body, and occupational therapy focuses on enhancing daily living skills and independence. Therefore, skeletal traction is the least likely treatment option among the choices provided.

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