Nursing Elites

1. A clinic nurse reviews the record of a child just seen by a doctor and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

• A. Pallor
• B. Hyperactivity
• C. Exercise intolerance
• D. Gastrointestinal disturbances

Correct answer: C

Rationale: Aortic stenosis is a condition characterized by the narrowing of the aortic valve, leading to reduced blood flow from the heart to the body. This narrowing restricts the amount of oxygenated blood that can reach various tissues, including muscles. As a result, individuals with aortic stenosis may experience exercise intolerance, as their muscles may not receive an adequate oxygen supply during physical activity. This can manifest as fatigue, shortness of breath, and overall decreased exercise capacity. Pallor (choice A) is a pale appearance that may be seen in anemia or other conditions affecting blood flow but is not specific to aortic stenosis. Hyperactivity (choice B) and gastrointestinal disturbances (choice D) are not typically associated with aortic stenosis.

2. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

3. In counseling the parents of a child with hypopituitarism, Nurse Gyimah is asked about their child's condition. Which of the following phrases, if stated by the nurse, best describes the condition?

• A. Linear growth retardation with skeletal proportions normal for chronologic age
• B. A complete normal growth pattern, but with the onset of precocious puberty
• C. Normal growth for the first five years, followed by progressive linear growth retardation
• D. Growth retardation in which height and weight are equally affected

Correct answer: A

Rationale: Hypopituitarism is characterized by linear growth retardation with skeletal proportions normal for chronologic age. This means that although the child experiences growth retardation, their skeletal proportions are appropriate for their age, which distinguishes it from other conditions like precocious puberty or equal height and weight affectation. Choice B is incorrect as hypopituitarism does not involve precocious puberty. Choice C is wrong as it describes a different growth pattern not typical of hypopituitarism. Choice D is also incorrect as in hypopituitarism, height and weight are not equally affected, rather the focus is on linear growth retardation with normal skeletal proportions.

4. You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?

• A. Inform the parents of your suspicions.
• B. Transport the child to the hospital regardless of the parents' wishes.
• C. Call the police and have the parents arrested.
• D. Advise the parents that the child needs to be transported.

Correct answer: D

Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported for further evaluation and care is the appropriate initial step. This ensures that the child receives necessary medical attention while also addressing the suspicion of abuse through proper channels. It is essential to involve appropriate authorities and follow established procedures to protect the child and investigate any potential abuse further.

5. Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?

• A. If your blood glucose levels are controlled, you can switch to using pills.
• B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
• C. Your body does not make insulin, so the insulin injections help to replace it.
• D. The pills work on the adult pancreas; you can switch when you are 18.

Correct answer: C

Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.

Similar Questions