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. 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 as an autosomal recessive trait.

Correct answer: A

Rationale: The correct answer is A: 'Mental retardation occurs if PKU is untreated.' Phenylketonuria (PKU) is a metabolic disorder that results in the inability to metabolize phenylalanine properly. Without proper dietary management, high levels of phenylalanine can lead to severe mental retardation and other neurological problems. Therefore, educating parents about the importance of early and consistent treatment to prevent mental retardation is crucial. Choice B is incorrect because testing for PKU is typically done shortly after birth, not immediately. Choice C is incorrect because treatment for PKU primarily involves strict dietary management to control phenylalanine intake, not lifelong medications. Choice D is incorrect because PKU is inherited in an autosomal recessive pattern, not as an autosomal dominant gene.

3. A 15-month-old child with the diagnosis of hydrocephalus is scheduled for a computed tomography (CT) scan. What should the nurse include when preparing the toddler for the CT scan?

• A. Shaving the head
• B. Starting the prescribed IV infusion
• C. Administering the prescribed sedative
• D. Giving the child a simple explanation of the procedure

Correct answer: D

Rationale: Preparing a toddler for a CT scan involves providing a simple explanation of the procedure to reduce anxiety and help the child understand what will happen. This approach helps establish trust and cooperation, making the experience less frightening for the child. Shaving the head, starting an IV infusion, or administering a sedative are not typically part of the preparation for a CT scan in a toddler and may not be necessary or appropriate in this scenario.

4. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. Absence of a urethral opening is noted
• B. Penis appears shorter than usual for age
• C. The urethral opening is along the dorsal surface of the penis
• D. The urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: In hypospadias, the urethral opening is located along the ventral surface of the penis. This congenital condition results in the urethral meatus opening on the underside of the penis, rather than at the tip. Choice A is incorrect as there is typically a urethral opening present, though in an abnormal location. Choice B is not a characteristic feature of hypospadias. Choice C is incorrect as the urethral opening in hypospadias is not along the dorsal surface but rather along the ventral surface of the penis.

5. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?

• A. Cellular metabolism is unstable in young children.
• B. The proportion of water in the body is less than in adults.
• C. Renal function is immature in children until they reach school age.
• D. The extracellular fluid requirement per unit of body weight is greater than in adults.

Correct answer: D

Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect as cellular metabolism instability does not directly relate to the infant's condition described. Choice B is inaccurate as the proportion of water in the body is not the primary issue causing the infant's symptoms. Choice C is incorrect as renal function being immature does not explain the sudden change in the infant's health status; it is more related to fluid balance and dehydration.

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