Nursing Elites

1. What should an adolescent with type 1 diabetes do 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: Choosing option B, 'Buy a soda and hamburger to eat,' is the most appropriate action for an adolescent with type 1 diabetes experiencing an insulin reaction during a basketball game. In this situation, the individual is likely experiencing hypoglycemia, and consuming a soda provides a quick source of sugar to raise blood glucose levels rapidly. The hamburger can offer a more sustained release of energy due to its protein and fat content. Option A is incorrect because while contacting parents for help may be necessary in some situations, immediate action to address hypoglycemia is crucial. Option C is incorrect because administering insulin would further lower blood sugar levels, worsening the condition. Option D is incorrect as leaving the arena without addressing the hypoglycemia can lead to a worsening of symptoms and potentially dangerous outcomes.

2. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: B

Rationale: The correct dietary instruction for a child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye, and it can exacerbate GERD symptoms in some individuals. Avoiding gluten can help reduce inflammation and irritation in the gastrointestinal tract, thereby alleviating symptoms of GERD. Choices A, C, and D are incorrect because while spicy foods, high-fat foods, and dairy products can trigger GERD symptoms in some individuals, avoiding gluten specifically is more relevant for managing GERD.

3. Parents of a sick infant talk with a nurse about their baby. One parent says, “I am so upset; I didn’t realize our baby was ill.” What major indication of illness in an infant should the nurse explain to the parent?

• A. Grunting respirations
• B. Excessive perspiration
• C. Longer periods of sleep
• D. Crying immediately after feedings

Correct answer: C

Rationale: The correct answer is C. Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it can indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, not just an indication of illness. Excessive perspiration (choice B) can occur due to various reasons and is not a specific major indication of illness. Crying immediately after feedings (choice D) is a common behavior in infants and not necessarily a major indication of illness.

4. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.

5. The nurse is assessing a 4-year-old client. Which finding suggests to the nurse this child may have a genetic disorder?

• A. The inquiry determines the child had feeding problems.
• B. The child weighs 40 lb (18.2 kg) and is 40 in (101.6 cm) in height.
• C. The child has low-set ears with lobe creases.
• D. The child can hop on one foot but cannot skip.

Correct answer: C

Rationale: Low-set ears with lobe creases are often associated with genetic disorders, such as Down syndrome, and can indicate underlying chromosomal abnormalities. This physical characteristic is a common feature seen in various genetic syndromes. The other choices, including feeding problems, weight and height measurements, and motor skills, are not typically specific indicators of genetic disorders in the absence of other associated features.

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