Nursing Elites

1. A toddler has minimal change nephrotic syndrome (MCNS) and 3+ pitting edema. Which intervention should the nurse include in the plan of care?

• A. Encourage an increased fluid intake for the toddler
• B. Place the child in an Airborne infection isolation room
• C. Increase the toddler's dietary sodium intake
• D. Administer corticosteroids to the toddler

Correct answer: D

Rationale: In managing minimal change nephrotic syndrome (MCNS) in children with pitting edema, corticosteroids are the mainstay of treatment. Corticosteroids help reduce inflammation and decrease proteinuria, addressing the underlying cause of MCNS. Therefore, the nurse should prioritize administering the prescribed corticosteroids to the toddler as part of the plan of care.

2. A young child admitted to the pediatric unit has fever, irritability, and vomiting with suspected bacterial meningitis. Which cerebrospinal fluid (CSF) result should the nurse anticipate based on these data?

• A. Decreased protein count
• B. Clear, straw-colored fluid
• C. Positive for red blood cells (RBCs)
• D. Decreased glucose level

Correct answer: D

Rationale: In bacterial meningitis, the glucose level in the cerebrospinal fluid (CSF) is typically decreased due to the increased utilization of glucose by the infecting bacteria. This metabolic change leads to a decrease in CSF glucose levels, making choice D the correct answer in this scenario. Choices A, B, and C are incorrect because bacterial meningitis usually results in an increased protein count, cloudy appearance of the CSF due to the presence of bacteria, and absence of red blood cells (RBCs) in the CSF unless there is a traumatic tap, respectively.

3. Mary is excited to work with the family of a friend with whom she has lost contact. Mary hopes the family will be able to connect her with her friend and is looking forward to hearing about her friend. At the next session, she asks the mother many questions about her friend and they spend a lot of time discussing their home town, etc. Which statement describes this scenario?

• A. It is not therapeutic: The relationship serves no purpose
• B. It is therapeutic: Therapist, child, and family have a reciprocal caring relationship
• C. It is not therapeutic: Mary is benefiting, but not the child and family
• D. It is therapeutic: Both parties are benefiting in the relationship

Correct answer: C

Rationale: In this scenario, Mary's focus on her own needs and interests by asking the mother about her lost friend and hometown indicates a lack of therapeutic benefit for the child and family. Effective therapy should prioritize the needs and goals of the child and family, not the therapist's personal desires or connections. Therefore, this interaction is not therapeutic as it fails to address the primary purpose of the therapy, which is to benefit the child and family. Choice A is incorrect because while the relationship may not be therapeutic, it does serve a purpose for Mary. Choice B is incorrect as there is no indication of a reciprocal caring relationship in this scenario. Choice D is incorrect as the focus is primarily on Mary's personal interests, rather than mutual benefit in the therapeutic relationship.

4. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

5. The therapist engages a teen in a game of cards to improve his hand skills for schoolwork. Which statement best reflects this session?

• A. Playfulness as an approach
• B. Play as an occupation
• C. Play as a tool
• D. Play as a reward

Correct answer: C

Rationale: The correct answer is 'Play as a tool.' In this session, the therapist is using play as a tool to integrate therapeutic goals into a playful activity, which helps engage the teen and improve specific skills, in this case, hand skills for schoolwork.

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