Nursing Elites

1. A 4-year-old child with a history of asthma is brought to the clinic with a complaint of cough and wheezing. The nurse notes that the child has been using a rescue inhaler more frequently over the past week. What should the nurse do next?

• A. Review the child’s asthma action plan
• B. Administer a dose of the rescue inhaler
• C. Instruct the parents to increase the dose of the controller medication
• D. Schedule a follow-up appointment in one week

Correct answer: A

Rationale: In this scenario, the best course of action for the nurse is to review the child's asthma action plan. By doing so, the nurse can assess the current asthma management, ensure that the child is using the rescue inhaler correctly, and make any necessary adjustments to the treatment plan. Reviewing the asthma action plan helps in identifying triggers, proper use of medications, and when to seek medical help. Administering a dose of the rescue inhaler without assessing the current management plan may not address the underlying issue. Instructing the parents to increase the dose of the controller medication without proper evaluation can lead to inappropriate medication adjustments. Scheduling a follow-up appointment in one week is not the immediate action needed to address the child's current symptoms.

2. The healthcare provider is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective?

• A. Creamed corn.
• B. Pancakes.
• C. Rye crackers.
• D. Cooked oatmeal.

Correct answer: A

Rationale: Creamed corn is a gluten-free food, making it a suitable option for clients with celiac disease. This choice indicates effective diet teaching as it aligns with the dietary restrictions necessary for managing the condition. Pancakes, rye crackers, and cooked oatmeal contain gluten, which is harmful to individuals with celiac disease. Therefore, they are not suitable choices and would not indicate effective teaching for a client with this condition.

3. Before administering a tube feeding to a child, what should the practical nurse (PN) assess?

• A. Tube placement.
• B. Bowel sounds.
• C. Abdominal circumference.
• D. Tube patency.

Correct answer: A

Rationale: Assessing tube placement is critical before initiating a tube feeding to verify its correct positioning in the stomach. This assessment helps prevent potential complications such as aspiration if the tube is incorrectly placed in the respiratory tract. Checking bowel sounds, abdominal circumference, and tube patency are important assessments in the care of a child receiving tube feedings, but ensuring proper tube placement takes precedence to ensure safe and effective delivery of nutrition.

4. The nurse is caring for a 15-year-old adolescent who is admitted with a diagnosis of bulimia nervosa. The adolescent’s vital signs are stable, but the nurse notes that the client has dry skin and appears thin. What is the nurse’s priority action?

• A. Initiate a structured eating plan for the client
• B. Establish a therapeutic relationship with the client
• C. Monitor the client’s electrolyte levels
• D. Provide education on healthy eating habits

Correct answer: C

Rationale: In clients with bulimia nervosa, electrolyte imbalances are common due to purging behaviors and can lead to severe complications. Monitoring electrolyte levels is essential to detect and manage any imbalances promptly, as they can be life-threatening.

5. A 7-year-old child is admitted to the hospital with nephrotic syndrome. The nurse notes that the child has gained 3 pounds in the past 24 hours. What should the nurse do first?

• A. Administer a diuretic as prescribed
• B. Restrict the child’s fluid intake
• C. Notify the healthcare provider
• D. Measure the child’s abdominal girth

Correct answer: C

Rationale: In a child with nephrotic syndrome experiencing sudden weight gain, the priority action for the nurse is to notify the healthcare provider. This weight gain could indicate worsening edema or fluid retention, necessitating immediate medical evaluation and intervention. The healthcare provider can conduct a comprehensive assessment, order necessary tests, and adjust the treatment plan accordingly. Administering a diuretic, restricting fluid intake, or measuring abdominal girth should not be initiated without healthcare provider consultation to ensure appropriate management of the child's condition.

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