Nursing Elites

1. A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?

• A. Increased weight gain
• B. Decreased heart rate
• C. Reduced headaches
• D. Diminished fatigue

Correct answer: B

Rationale: When a child with Graves' disease is prescribed propranolol (Inderal), the nurse should monitor for a decreased heart rate as a therapeutic response. Propranolol is a beta-blocker that acts to slow down the heart rate, which is beneficial in managing the symptoms of Graves' disease, such as tachycardia and other cardiovascular manifestations. Choices A, C, and D are incorrect because propranolol is not typically associated with increased weight gain, reduced headaches, or diminished fatigue as its primary therapeutic effect in this context.

2. How should the caregiver instruct on caring for a 4-month-old with seborrheic dermatitis (cradle cap) when shampooing the child's hair?

• A. Use a soft brush and gently scrub the area.
• B. Avoid scrubbing the scalp until the scales disappear.
• C. Avoid washing the child's hair more than once a week.
• D. Use soap and water and avoid shampoos.

Correct answer: A

Rationale: When dealing with seborrheic dermatitis (cradle cap) in infants, it is essential to use a soft brush and gently scrub the affected area to help remove the scales. This process can aid in managing the condition and preventing further build-up. It is important to be gentle to avoid irritating the baby's delicate skin. Choice B is incorrect as gentle scrubbing with a soft brush can help in the removal of scales. Choice C is incorrect because regular but gentle washing is recommended to manage cradle cap. Choice D is incorrect as using specialized shampoos designed for cradle cap is usually recommended over soap and water.

3. When reinforcing information about the use of corticosteroids in treating asthma in children, which statement indicates that the parent understands the teaching?

• A. My child should take the medication only when experiencing symptoms.
• B. I will rinse my child's mouth after each use of the inhaler.
• C. I should discontinue the medication if my child seems better.
• D. Corticosteroids are used for quick relief during an asthma attack.

Correct answer: B

Rationale: Rinsing the mouth after using corticosteroid inhalers is crucial as it helps prevent oral thrush, a common side effect associated with these medications. This practice reduces the risk of developing fungal infections in the mouth and throat, maintaining optimal oral health during asthma treatment.

4. A mother brings her 3-week-old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life-threatening complication?

• A. Irregular palpable pulse
• B. Hyperactive bowel sounds
• C. Underweight for age
• D. Crying without tears

Correct answer: D

Rationale: Crying without tears is a sign of severe dehydration, which is a potentially life-threatening complication in infants with projectile vomiting. Dehydration can rapidly progress in infants, leading to serious consequences if not promptly addressed. The combination of projectile vomiting, listlessness, and absence of tears when crying should raise concerns about severe dehydration and the need for urgent intervention to prevent further complications.

5. What information should a nurse discuss with the mother of a 2-year-old girl who is drinking sweetened soda from her bottle?

• A. Encouraging 2-word phrases in speech development for a 2-year-old
• B. Explaining the association between drinking soda and dental caries
• C. Discussing the link between drinking soda and childhood obesity
• D. Emphasizing the importance of toddlers sleeping 10 hours a night

Correct answer: B

Rationale: The correct answer is explaining the association between drinking soda and dental caries. Soda consumption can lead to tooth decay and cavities, so it is crucial to educate the mother about this to prevent dental issues in the child.

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