Nursing Elites

1. A nurse is caring for a child with a diagnosis of acute lymphoblastic leukemia (ALL). What is the priority nursing intervention?

• A. Administering chemotherapy
• B. Preventing infection
• C. Monitoring for signs of bleeding
• D. Providing nutritional support

Correct answer: A

Rationale: The correct answer is A: Administering chemotherapy. In the care of a child with acute lymphoblastic leukemia (ALL), the priority nursing intervention is administering chemotherapy. Chemotherapy is the primary treatment for ALL and plays a crucial role in managing the disease. While preventing infection, monitoring for signs of bleeding, and providing nutritional support are important aspects of caring for a child with ALL, administering chemotherapy takes precedence as it directly targets the cancer cells and aims to induce remission.

2. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?

• A. Syndrome of inappropriate antidiuretic hormone (SIADH)
• B. Thyroid storm
• C. Cushing syndrome
• D. Vitamin D toxicity

Correct answer: A

Rationale: The correct answer is A: Syndrome of inappropriate antidiuretic hormone (SIADH). Vasopressin is a medication used to treat diabetes insipidus by increasing water reabsorption in the kidneys. However, an excessive dose of vasopressin can lead to water retention, causing SIADH, which is characterized by dilutional hyponatremia. Choices B, C, and D are incorrect. Thyroid storm is a severe form of hyperthyroidism characterized by increased metabolism and can lead to life-threatening complications. Cushing syndrome results from excess cortisol production and is characterized by weight gain, hypertension, and other features. Vitamin D toxicity occurs due to an overdose of vitamin D, leading to hypercalcemia and symptoms such as nausea, vomiting, and weakness.

3. An 18-month-old was brought to the emergency department by her mother, who states, 'I think she broke her arm.' The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

• A. Plastic deformity
• B. Buckle fracture
• C. Spiral fracture
• D. Greenstick fracture

Correct answer: C

Rationale: A spiral fracture is a type of fracture often associated with twisting injuries and can raise suspicion of child abuse. This type of fracture is caused by a twisting force applied to a bone. Plastic deformity is not typically associated with fractures but refers to the ability of a material to change shape and retain that shape. A buckle fracture, also known as a torus fracture, is an incomplete break in a bone commonly seen in children. A greenstick fracture is an incomplete fracture where the bone is bent and partially broken, more commonly seen in children due to their bone flexibility.

4. A child with a diagnosis of congenital heart disease is admitted to the hospital. What should the nurse include in the child’s care plan?

• A. Monitoring fluid status
• B. Encouraging activity
• C. Promoting a high-calorie diet
• D. Maintaining oxygen therapy

Correct answer: A

Rationale: Monitoring fluid status is crucial for a child with congenital heart disease because these children are at risk of fluid overload, which can exacerbate their condition. Monitoring fluid intake and output helps prevent complications such as heart failure. Encouraging activity may be important, but it should be done cautiously and within limits due to the child's cardiac condition. Promoting a high-calorie diet is not typically a priority in congenital heart disease care unless there are specific indications. Maintaining oxygen therapy may be necessary in some cases but is not the primary intervention for managing congenital heart disease.

5. A nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit for it to be most productive?

• A. When the husband is out of the home.
• B. At a time when the mother is feeding the infant.
• C. At a time that is convenient for the family.
• D. When the nurse can spend time with the family.

Correct answer: C

Rationale: Scheduling the visit at a time that is convenient for the family is the most appropriate choice. This ensures that the family is receptive and available, making the visit more productive. Choice A is incorrect because the presence of the husband may be important for support and decision-making. Choice B focuses solely on the mother and the infant's feeding time, which may not align with the family's overall availability. Choice D is incorrect as it emphasizes the nurse's convenience rather than the family's, which may not lead to an effective visit.

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