Nursing Elites

1. Why should a nurse plan an evening snack for a child receiving Novolin N insulin?

• A. To encourage the child to adhere to the diet.
• B. To provide energy for immediate use.
• C. To help the child gain weight with extra calories.
• D. To counteract late insulin activity with nourishment.

Correct answer: D

Rationale: The correct answer is D. Novolin N insulin peaks in the evening, which can lead to hypoglycemia during the night. Providing an evening snack helps to counteract the late insulin activity and prevent hypoglycemia. Choice A is incorrect because the primary reason for the evening snack is not to encourage adherence to the diet. Choice B is incorrect as the snack is not primarily for immediate energy use. Choice C is incorrect as the goal of the snack is not to help the child gain weight but to manage blood sugar levels.

2. What clinical manifestation of tetralogy of Fallot should the nurse expect when caring for children with this diagnosis?

• A. Slow respirations
• B. Clubbing of fingers
• C. Decreased RBC counts
• D. Subcutaneous hemorrhages

Correct answer: B

Rationale: Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. Clubbing occurs as a result of long-standing decreased oxygen levels in the blood, leading to changes in the fingertips. Slow respirations (Choice A) are not typically a direct clinical manifestation of tetralogy of Fallot. While decreased RBC counts (Choice C) may occur due to chronic hypoxia, they are not a primary manifestation specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a common clinical manifestation associated with tetralogy of Fallot.

3. What are the most common signs and symptoms of leukemia related to bone marrow involvement?

• A. petechiae, infection, fatigue
• B. headache, papilledema, irritability
• C. muscle wasting, weight loss, fatigue
• D. decreased intracranial pressure, psychosis, confusion

Correct answer: A

Rationale: Petechiae, infection, and fatigue are common signs and symptoms of leukemia related to bone marrow involvement. Petechiae are small red or purple spots on the skin caused by bleeding under the skin due to low platelet counts. Infection susceptibility increases due to decreased white blood cells from compromised bone marrow function. Fatigue is a common symptom of anemia resulting from decreased red blood cell production. Choices B, C, and D are incorrect as they do not align with the typical signs and symptoms of leukemia associated with bone marrow dysfunction.

4. A child is admitted to the hospital with pneumonia. What is the priority need that must be included in the nursing plan of care for this child?

• A. Rest
• B. Exercise
• C. Nutrition
• D. Elimination

Correct answer: A

Rationale: The correct answer is A: Rest. When a child is admitted to the hospital with pneumonia, the priority need in the nursing plan of care is to ensure adequate rest. Rest is crucial as it allows the child's body to fight the infection and recover. Choice B, Exercise, would not be appropriate as the child needs rest to conserve energy and promote healing. Choice C, Nutrition, is important for overall health but may not be the immediate priority when the child is acutely ill with pneumonia. Choice D, Elimination, is important but is not the priority need in this scenario compared to ensuring rest to aid recovery from pneumonia.

5. A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler’s 15-month visit, the healthcare provider prescribed 150 mg. What is the nurse’s best response to the parent?

• A. “The dose is close enough, and it doesn’t really matter which one is given.”
• B. “From your description, the medication is not necessary. It should be avoided at this age.”
• C. “It is appropriate to use dosages based on age. Children typically have weights consistent for their age groups.”
• D. “The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose.”

Correct answer: D

Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing accounts for individual variations in drug metabolism and distribution, ensuring a more precise and safer medication administration. Choices A, B, and C are incorrect as they do not address the importance of weight-based dosing in children, potentially leading to inappropriate dosing and safety concerns.

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