Nursing Elites

1. What information should the practical nurse ensure the family understands about caring for a child with a tracheostomy?

• A. Cardiopulmonary resuscitation.
• B. Hygiene practices, including showering.
• C. Proper technique for tracheostomy suctioning.
• D. Application of powder around the stoma.

Correct answer: A

Rationale: The correct answer is A: Cardiopulmonary resuscitation. It is essential for families to be educated in cardiopulmonary resuscitation (CPR) to manage emergencies involving patients with tracheostomies. Maintaining a clear airway is crucial for the child's safety and well-being. Choice B, hygiene practices, although important, is not as critical as CPR in managing a tracheostomy. Choice C, the proper technique for tracheostomy suctioning, is also crucial but does not take precedence over CPR in emergency situations. Choice D, application of powder around the stoma, is not a standard practice and may not be necessary for tracheostomy care.

2. Which drink choice on a hot day indicates that a teenager with sickle cell anemia understands dietary considerations related to the disease?

• A. Milkshake
• B. Iced tea
• C. Diet cola
• D. Lemonade

Correct answer: D

Rationale: Lemonade is the correct choice for a teenager with sickle cell anemia as it provides hydration without caffeine, which is important for individuals with this condition. Caffeine can lead to dehydration, vasoconstriction, and potentially worsen symptoms in sickle cell anemia patients. Milkshake (choice A) may contain dairy, which can be high in fat and may not be the best choice for someone with sickle cell anemia. Iced tea (choice B) and diet cola (choice C) both contain caffeine, which should be avoided by individuals with sickle cell anemia due to its dehydrating effects.

3. A mother brings her 8-month-old baby boy to the clinic because he has been vomiting and having diarrhea for the last 3 days. Which assessment is most important for the nurse to make?

• A. Assess the infant's abdomen for tenderness
• B. Determine if the infant has been exposed to a virus
• C. Measure the infant’s pulse
• D. Evaluate the infant’s cry

Correct answer: C

Rationale: The most crucial assessment in this scenario is to measure the infant's pulse. Pulse measurement is essential to evaluate the severity of dehydration, which can be a significant concern in a baby experiencing vomiting and diarrhea for several days. Assessing the abdomen for tenderness may provide information on potential causes of symptoms but is not as urgent as monitoring hydration status. Determining exposure to a virus is important for infection control but does not directly address the immediate issue of dehydration. Evaluating the infant's cry, although a form of communication, does not provide critical information regarding the baby's physiological status in this situation.

4. A 14-year-old client with type 1 diabetes is participating in a school sports event. The nurse provides education to the client about managing blood glucose levels during physical activity. Which statement by the client indicates a need for further teaching?

• A. I should check my blood sugar before and after exercise
• B. I need to eat a snack before I start playing
• C. If my blood sugar is high, I should skip my insulin dose before exercise
• D. I should carry a fast-acting carbohydrate with me during sports

Correct answer: C

Rationale: The correct answer is C. Skipping the insulin dose when blood sugar is high before exercise can be harmful. It is essential to manage blood glucose levels carefully during physical activity, which may require adjustments to insulin doses but skipping doses is not recommended. Checking blood sugar before and after exercise (Choice A) helps in monitoring and managing blood glucose levels. Eating a snack before playing (Choice B) can help maintain blood sugar levels during physical activity. Carrying a fast-acting carbohydrate (Choice D) is important in case of low blood sugar during sports to quickly raise glucose levels. Therefore, the client needs further teaching on the importance of not skipping insulin doses even if blood sugar is high before exercise.

5. The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?

• A. I will ask the HCP for a psychiatric consult for your child'
• B. This type of acting out behavior is normal for adolescents'
• C. It is important to focus on your child’s needs at this difficult time'
• D. A reaction of anger is your child’s attempt to cope with this loss'

Correct answer: D

Rationale: Acknowledging the child's anger as part of the coping process helps the mother understand her child's emotional response.

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