Nursing Elites

1. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Meals should be eaten at home.
• B. Foods should be weighed using a gram scale.
• C. A ready source of glucose should be available.
• D. Specific foods should be cooked for the adolescent.

Correct answer: C

Rationale: The correct answer is C: A ready source of glucose should be available. When managing type 1 diabetes, it is crucial to have a quick source of glucose readily available in case of hypoglycemia. This ensures that the adolescent can quickly raise their blood sugar levels to prevent complications. Choices A, B, and D are incorrect as they do not address the immediate need for glucose in managing hypoglycemia. While it is important for meals to be consumed regularly and in a controlled manner, specifying that they should be eaten at home or foods weighed using a gram scale is not as critical as ensuring a quick source of glucose in emergency situations.

2. An 8-year-old child with the diagnosis of meningitis is to have a lumbar puncture. What should the nurse explain is the purpose of this procedure?

• A. To measure the pressure of cerebrospinal fluid
• B. To obtain a sample of cerebrospinal fluid for analysis
• C. To relieve intracranial pressure
• D. To assess the presence of infection in the spinal fluid

Correct answer: B

Rationale: The primary purpose of a lumbar puncture is to obtain a sample of cerebrospinal fluid for analysis. This sample helps in diagnosing conditions such as meningitis by evaluating the presence of pathogens or abnormalities in the cerebrospinal fluid. Measuring the pressure of cerebrospinal fluid (Choice A) is not the main objective of a lumbar puncture, although it can be done during the procedure. Relieving intracranial pressure (Choice C) is not the direct purpose of a lumbar puncture, as other interventions are typically used for this purpose. Assessing the presence of infection in the spinal fluid (Choice D) is related to the overall goal of obtaining a sample for analysis, making it a secondary outcome of the procedure.

3. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

4. The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What symptom would the nurse correlate with the disorder?

• A. The parents report that their child had a recent 'cold or flu.'
• B. Blood pressure is decreased during vital signs assessment.
• C. The parents report that their son 'can’t drink enough water.'
• D. Auscultation reveals Kussmaul breathing.

Correct answer: C

Rationale: The correct answer is C. In type 2 diabetes mellitus, excessive thirst (polydipsia) is a common symptom due to high blood glucose levels. This results in the patient feeling unable to drink enough water to satisfy their thirst. The other options are incorrect because a recent 'cold or flu' (choice A) is not directly related to diabetes mellitus, decreased blood pressure (choice B) is not a typical finding in uncontrolled diabetes, and Kussmaul breathing (choice D) is associated with diabetic ketoacidosis, which is more common in type 1 diabetes mellitus.

5. What is the appropriate therapeutic management for children with Hirschsprung disease?

• A. daily enemas
• B. low-fiber diet
• C. permanent colostomy
• D. surgical removal of the affected section of bowel

Correct answer: D

Rationale: The correct answer is D: surgical removal of the affected section of bowel. Hirschsprung disease is characterized by a segment of the colon lacking nerve cells, leading to obstruction. The definitive treatment involves surgically removing the affected segment, followed by a pull-through procedure to restore normal bowel continuity. Daily enemas (choice A) are not the primary treatment for Hirschsprung disease. While dietary adjustments may be advised, a low-fiber diet (choice B) alone is not curative for this condition. A permanent colostomy (choice C) is considered a last resort if surgical interventions fail or in severe cases, but it is not the initial therapeutic approach for managing Hirschsprung disease.

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