Nursing Elites

1. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

2. The nurse is obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism. What would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism in infants often leads to lethargy and difficulty staying awake due to low thyroid hormone levels. Assessing the child's ability to stay awake is crucial in identifying signs of hypothyroidism. Choices A, B, and C are incorrect because above-normal growth, being active and playful, and having healthy-looking skin are not typical manifestations of congenital hypothyroidism. Instead, infants with hypothyroidism may exhibit poor weight gain, decreased activity, and dry, pale skin.

3. A child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger or worsen symptoms. Monitoring dietary habits helps identify any potential triggers and ensures proper nutrition, which can impact asthma control. Assessing sleep patterns, academic performance, or behavior at home may provide valuable information in a general health assessment, but when specifically managing asthma, dietary intake assessment is the most relevant.

4. A group of nursing students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The correct answer is 'Hormonal secretion' (Choice B). The primary function of the endocrine system is to secrete hormones that regulate various bodily functions such as metabolism, growth, and reproduction. Choice A, 'Regulation of water balance,' is primarily controlled by the kidneys and the urinary system, not the endocrine system. Choice C, 'Cellular metabolism,' is more directly related to the functions of individual cells rather than the overall function of the endocrine system. Choice D, 'Growth stimulation,' is a function that can be influenced by hormones secreted by the endocrine system, but it is not the primary function of the system.

5. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

• A. They will increase tidal volumes.
• B. Drainage of air and fluid will be facilitated.
• C. They will maintain positive intrapleural pressure.
• D. Pressure on the pericardium and chest wall will be regulated.

Correct answer: B

Rationale: Chest tubes are used to drain air and fluid from the chest cavity to prevent complications such as pneumothorax or cardiac tamponade after surgery. Choice A is incorrect as chest tubes are not used to increase tidal volumes. Choice C is incorrect as chest tubes do not maintain positive intrapleural pressure; instead, they assist in removing excess air or fluid. Choice D is incorrect as chest tubes do not regulate pressure on the pericardium and chest wall; they primarily aid in drainage.

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