Nursing Elites

1. What is the probable cause recognized by the nurse when a 5-year-old boy is admitted to the hospital with acute glomerulonephritis?

• A. Recovery from German measles 2 months ago
• B. Dysuria since the previous night
• C. A history of allergy
• D. A sore throat 2 weeks ago

Correct answer: D

Rationale: Acute glomerulonephritis typically develops 1 to 3 weeks after a streptococcal infection, such as a sore throat, which triggers an allergic-type response that affects the glomeruli's function. This immune response leads to inflammation and damage to the glomeruli, resulting in acute glomerulonephritis.

2. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?

• A. Increased PCO2 and respiratory acidosis
• B. Decreased PCO2 and respiratory alkalosis
• C. Low pH and low PCO2
• D. High pH and high PCO2

Correct answer: A

Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).

3. When teaching a parent of a child with contact dermatitis, which instruction should the nurse include?

• A. Apply a thick layer of antibiotic ointment to the affected area.
• B. Rub the skin vigorously with a towel to dry it.
• C. Keep the child's skin dry.
• D. Apply a thin layer of corticosteroid cream to the affected area.

Correct answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

4. During a home care visit for an infant diagnosed with gastroesophageal reflux, which parental action observed requires intervention by the nurse?

• A. The infant's formula is mixed with rice cereal.
• B. The mother positions the infant in a high Fowler position while feeding.
• C. After feeding, the infant is placed in a car seat.
• D. The mother administers ranitidine (Zantac) to the infant using a syringe.

Correct answer: C

Rationale: Placing an infant diagnosed with gastroesophageal reflux in a car seat after feeding can increase the risk of reflux and aspiration. The semi-upright or high Fowler position is recommended to help reduce reflux symptoms during feeding. Adding rice cereal to formula can help thicken it and reduce reflux episodes. Administering ranitidine using a syringe is a common method of oral medication administration. Therefore, the action of placing the infant in a car seat after feeding is the one that requires intervention due to the increased risk it poses.

5. What is the recommended sleep duration for 14-17-year-olds?

• A. 14-17 hours
• B. 8-10 hours
• C. 12-15 hours
• D. 9-11 hours

Correct answer: B

Rationale: The recommended sleep duration for adolescents aged 14-17 is 8-10 hours to promote optimal health. Getting enough sleep is crucial for their physical and mental well-being, as it supports growth, development, learning, and overall health.

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