Nursing Elites

1. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?

• A. Impaired Gas Exchange
• B. Risk for Infection
• C. Anxiety (parental)
• D. Acute Pain

Correct answer: A

Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.

2. During the oliguric phase of acute kidney injury, what intervention should be included in the plan of care for a child?

• A. Administer a loop diuretic.
• B. Provide a low-sodium diet.
• C. Weigh the child weekly.
• D. Provide a high-protein diet.

Correct answer: A

Rationale: During the oliguric phase of acute kidney injury, the priority is managing fluid balance. Administering a loop diuretic is crucial to promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly is important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase, as it can put additional stress on the kidneys.

3. A 4-year-old client with intractable seizures has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided pain. Which possible complication to this diet does the nurse suspect?

• A. Appendicitis
• B. Bowel obstruction
• C. Urinary tract infection
• D. Kidney stones

Correct answer: D

Rationale: The ketogenic diet increases the risk of kidney stones.

4. A child with glomerulonephritis receiving corticosteroid treatment requires dietary teaching. What instruction should the nurse provide to the parent?

• A. Increase the child's intake of potassium-rich foods.
• B. Encourage the child to eat low-calorie snacks.
• C. Offer the child a variety of fresh fruits.
• D. Restrict the child's fluid intake.

Correct answer: C

Rationale: The correct answer is to offer the child a variety of fresh fruits. Glomerulonephritis and corticosteroid use can lead to potassium depletion. Fresh fruits are a good source of potassium, which can help counteract the depletion caused by corticosteroids. Encouraging a variety of fresh fruits can provide necessary nutrients and help maintain a balanced diet for the child.

5. A healthcare provider is assessing a child with acute lymphocytic leukemia. Which of the following findings is the priority for the healthcare provider to report?

• A. Bruising
• B. Petechiae
• C. Elevated WBC count
• D. Elevated platelet count

Correct answer: B

Rationale: The priority finding to report for a child with acute lymphocytic leukemia is petechiae. Petechiae indicate a low platelet count, which increases the risk of bleeding. Therefore, the healthcare provider should promptly report petechiae to initiate appropriate interventions to prevent bleeding complications.

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