Nursing Elites

1. A child was brought to the emergency department with complaints of nausea, vomiting, and fruity-scented breath. The resident on duty diagnosed the child with diabetic ketoacidosis. Which of the following should the nurse expect to administer?

• A. Potassium chloride IV infusion.
• B. Dextrose 5% IV infusion.
• C. Ringer's Lactate.
• D. Normal saline IV infusion

Correct answer: D

Rationale: In diabetic ketoacidosis (DKA), there is a state of dehydration and electrolyte imbalance. Normal saline is the initial fluid of choice to help restore intravascular volume and improve electrolyte balance. It also helps to correct acidosis. Potassium chloride IV infusion is commonly added to the treatment regimen once kidney function is confirmed to prevent hypokalemia. Dextrose 5% IV infusion is not the first-line treatment for DKA as it can worsen hyperglycemia. Ringer's Lactate is not typically used as the initial fluid for managing DKA as it contains potassium and could worsen hyperkalemia.

2. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:

• A. allowing the parents to transport the child.
• B. offering oxygen and providing transport.
• C. rapidly cooling the child in cold water.
• D. keeping the child warm and providing transport.

Correct answer: B

Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.

3. Serwaa, a 26-year-old mother has brought her daughter to the OPD with signs of lower respiratory tract infections. The following are the diagnoses that can be given to the daughter except:

• A. Pneumonia
• B. Asthma
• C. Bronchiolitis
• D. Coryza

Correct answer: D

Rationale: Coryza, also known as the common cold, primarily affects the upper respiratory tract and is not typically associated with lower respiratory tract infections. Pneumonia, asthma, and bronchiolitis are conditions that can manifest as lower respiratory tract infections.

4. A 4-year-old boy ingested an unknown quantity of drain cleaner. He is alert, has a patent airway, and has adequate breathing. You should:

• A. administer 1 g/kg of activated charcoal.
• B. give 15 mL of ipecac and contact medical control.
• C. contact poison control and give him oxygen.
• D. give oxygen and perform a head-to-toe exam.

Correct answer: C

Rationale: When a child ingests a harmful substance like drain cleaner and remains alert with a patent airway and adequate breathing, the initial steps involve contacting poison control to guide further management. In this scenario, providing oxygen to support respiratory function is essential until definitive care is established. Activated charcoal and ipecac are not recommended in the management of ingested caustic substances like drain cleaner. Performing a head-to-toe exam can wait until the child's immediate respiratory needs are addressed and the poison control center has provided guidance on further management.

5. What is the leading cause of death in geriatric patients?

• A. Hypertension.
• B. Arthritis.
• C. Heart disease.
• D. Altered mental status.

Correct answer: C

Rationale: Heart disease is the leading cause of death in geriatric patients. It encompasses a range of conditions affecting the heart and blood vessels, such as coronary artery disease and heart failure, which are more prevalent in older individuals. These conditions can lead to serious complications and ultimately result in higher mortality rates among the elderly population. Hypertension (choice A) is a risk factor for heart disease but not the leading cause of death in geriatric patients. Arthritis (choice B) is a chronic condition affecting the joints, not a primary cause of death in this population. Altered mental status (choice D) is a symptom rather than a leading cause of death in geriatric patients.

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