Nursing Elites

1. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?

• A. Encourage participation in physical activity
• B. Provide a high-calorie diet
• C. Provide a low-sodium diet
• D. Administer intravenous fluids

Correct answer: A

Rationale: Encouraging regular physical activity is essential in managing symptoms and improving joint function in juvenile idiopathic arthritis. Physical activity helps maintain joint mobility, muscle strength, and overall function. Providing a high-calorie diet may not be necessary unless there are specific concerns about the child's nutritional status. A low-sodium diet is not typically a priority in the management of JIA unless the child has comorbid conditions requiring sodium restriction. Administering intravenous fluids is not a standard discharge teaching for JIA unless there are specific medical indications necessitating it.

2. What is an important nursing responsibility when a dysrhythmia is suspected?

• A. Order an immediate electrocardiogram
• B. Count the radial pulse every minute for five times
• C. Count the apical pulse for 1 full minute and compare the rate with the radial pulse rate
• D. Have someone else take the radial pulse simultaneously with the apical pulse

Correct answer: C

Rationale: When a dysrhythmia is suspected, it is important for nurses to count the apical pulse for a full minute and compare it with the radial pulse rate. This method helps in identifying dysrhythmias because discrepancies between the apical and radial pulse rates can indicate irregular heart rhythms. Option A is incorrect because ordering an immediate electrocardiogram may not always be feasible or necessary as a first step. Option B, counting the radial pulse multiple times, is less accurate than comparing the apical and radial pulse rates. Option D involves an unnecessary step of having another person take simultaneous pulses when the nurse can do it effectively alone.

3. The mother of a 5-year-old boy with a myelomeningocele, who has developed a sensitivity to latex, is being taught by the nurse. Which response from his mother indicates a need for further teaching?

• A. He needs to wear a medical alert identification.
• B. I will need to inform his caregivers about his latex sensitivity.
• C. A product's label always indicates whether it is latex-free.
• D. He must avoid any contact with latex.

Correct answer: C

Rationale: Choice C, 'A product's label always indicates whether it is latex-free,' indicates a need for further teaching. Not all products are clearly labeled as latex-free; therefore, it is essential to verify with manufacturers and healthcare providers. Choices A, B, and D demonstrate appropriate understanding of managing latex sensitivity in the child. Wearing a medical alert identification (Choice A), informing caregivers (Choice B), and avoiding all contact with latex (Choice D) are all important aspects of managing a child's latex sensitivity.

4. What is the most common cause of shock (hypoperfusion) in infants and children?

• A. infection
• B. cardiac failure
• C. accidental poisoning
• D. severe allergic reaction

Correct answer: A

Rationale: Infection is the leading cause of shock in infants and children due to their heightened vulnerability to sepsis. Infants and children possess developing immune systems, rendering them more susceptible to infections that can progress to septic shock. While cardiac failure is a severe condition, it is not as commonly the primary cause of shock in this age group. Accidental poisoning, though a potential shock inducer, is less prevalent in infants and children compared to infections. Severe allergic reactions, though significant, are not as frequent as infections in precipitating shock in infants and children.

5. When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?

• A. They may occur in minor illnesses.
• B. The cause is usually readily identified.
• C. They usually do not occur during the toddler years.
• D. The frequency of occurrence is greater in females than males.

Correct answer: A

Rationale: The correct answer is A: 'They may occur in minor illnesses.' Febrile seizures can occur even in minor illnesses, particularly in young children, and are often triggered by a rapid increase in body temperature. Choice B is incorrect because the cause of febrile seizures is not always readily identified. Choice C is incorrect as febrile seizures commonly occur in children between the ages of 6 months to 5 years, which includes the toddler years. Choice D is incorrect as febrile seizures are slightly more common in males than females.

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