Nursing Elites

1. After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?

• A. A balance of rest and exercise is important.
• B. I can apply lotion or powder to the incision if it is itchy.
• C. Activities in which falling could occur need to be avoided for two to four weeks.
• D. Large crowds of people need to be avoided for at least two weeks after the surgery.

Correct answer: B

Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.

2. 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.

3. When discussing heart conditions, a healthcare provider explains a condition in which the lungs retain extra fluid due to left ventricular impairment. What is this condition?

• A. Whooping cough
• B. Pneumonia
• C. Asthma
• D. Pulmonary edema

Correct answer: D

Rationale: Pulmonary edema is the correct answer. It is a condition characterized by the retention of extra fluid in the lungs, often due to left ventricular impairment. This fluid buildup can lead to symptoms such as shortness of breath, coughing, and difficulty breathing. Whooping cough (Choice A), pneumonia (Choice B), and asthma (Choice C) are not conditions related to the retention of fluid in the lungs due to left ventricular impairment. Whooping cough is a bacterial respiratory infection, pneumonia is an infection that inflames the air sacs in one or both lungs, and asthma is a chronic respiratory condition characterized by airway inflammation and constriction.

4. What is the term for a condition where there is a failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children, with 80% of cases being idiopathic? It may present with familial patterns, affecting males more than females.

• A. Cretinism
• B. Growth hormone deficiency
• C. Hypothyroidism
• D. Precocious puberty

Correct answer: B

Rationale: Growth hormone deficiency refers to a condition where there is inadequate production of growth hormone by the pituitary gland. This results in impaired growth in children. While 80% of cases are of unknown cause (idiopathic), some may have familial patterns. It is more common in males than females. Cretinism is a condition of severe hypothyroidism during infancy, not related to growth hormone. Hypothyroidism is a disorder involving low thyroid hormone levels, and precocious puberty is the early onset of puberty. Therefore, the correct answer is 'Growth hormone deficiency.'

5. How can a new mother tell if her baby is getting enough breast milk?

• A. If your baby sleeps through the night, they are getting enough milk.
• B. If your baby has six to eight wet diapers a day, they are getting enough milk.
• C. If your baby cries frequently, they are getting enough milk.
• D. If your baby is awake and alert, they are getting enough milk.

Correct answer: B

Rationale: The correct answer is B. If a new mother observes that her baby has six to eight wet diapers a day, it indicates that the baby is getting enough breast milk. This is a crucial indicator of adequate milk intake and hydration in infants. Conversely, choices A, C, and D are incorrect. A baby sleeping through the night, crying frequently, or being awake and alert are not reliable indicators of sufficient breast milk intake. It is essential for new mothers to track their baby's diaper output to ensure they are receiving the necessary nutrition.

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