Nursing Elites

1. 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.

2. A 12-year-old child is admitted to the hospital with a diagnosis of osteomyelitis. Which finding should the nurse expect during the assessment?

• A. Localized pain and swelling
• B. Generalized joint stiffness
• C. Pain in the muscles
• D. Limited range of motion in the limbs

Correct answer: A

Rationale: In osteomyelitis, an infection of the bone, patients typically present with localized pain, swelling, and warmth over the affected bone. This is due to the inflammatory response in the bone tissue. Generalized joint stiffness, pain in the muscles, and limited range of motion in the limbs are not specific to osteomyelitis and are more commonly associated with other conditions.

3. The infant scheduled for reduction of intussusception passes a soft-formed brown stool the day before the procedure. What intervention should the nurse implement?

• A. Instruct the parents that the infant needs to be NPO.
• B. Notify the healthcare provider of the passage of brown stool.
• C. Obtain a stool specimen for laboratory analysis.
• D. Ask the parents about recent changes in the infant's diet.

Correct answer: B

Rationale: Notifying the healthcare provider is crucial when an infant scheduled for intussusception reduction passes a soft-formed brown stool as it may indicate spontaneous reduction of the intussusception. The healthcare provider needs to be informed to assess if the procedure is still necessary or if further evaluation is required. Instructing the parents that the infant needs to be NPO (nothing by mouth) is not the immediate action required in this situation. Obtaining a stool specimen for laboratory analysis is not necessary as the soft-formed brown stool is likely a result of the intussusception spontaneously reducing. Asking about recent changes in the infant's diet is not the most appropriate action when brown stool is passed before the procedure for intussusception reduction.

4. 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.

5. A child receives a prescription for amantadine 42 mg PO BID. Amantadine is available as a 50 mg/5 mL syrup. Using a supplied calibrated measuring device, how many mL should be administered per dose? (Round to the nearest tenth.)

• A. 4.2 mL
• B. 5 mL
• C. 3.6 mL
• D. 4 mL

Correct answer: A

Rationale: To calculate the mL per dose, divide the prescribed dose (42 mg) by the concentration of the syrup (50 mg/5 mL) and then convert the result to mL. 42 mg / 50 mg = 0.84. To find the amount in mL, multiply 0.84 by 5 mL, which equals 4.2 mL. Therefore, 4.2 mL should be administered per dose.

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