Nursing Elites

1. 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.

2. A healthcare professional is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The professional should identify which of the following laboratory values indicates effectiveness of the current treatment?

• A. Potassium 2.9 mEq/L
• B. Sodium 140 mEq/L
• C. Urine specific gravity 1.035
• D. BUN 25 mg/dL

Correct answer: B

Rationale: A sodium level of 140 mEq/L within the expected reference range indicates effective treatment for dehydration. In dehydration, sodium levels are often elevated, so a normal sodium level suggests that the treatment is helping to restore the electrolyte balance in the infant's body.

3. Which question provides information regarding a child's community mobility?

• A. What is the level of supervision provided?
• B. Can the child leave the house and play with friends?
• C. Is the child being bullied?
• D. Is there equipment available so the child can play with peers?

Correct answer: B

Rationale: Choice B directly assesses the child's community mobility by inquiring about their ability to leave the house and engage in play activities with friends. Community mobility involves the child's independence in social and recreational activities outside the home, making this question crucial for understanding their daily functioning and autonomy.

4. A nurse provides dietary teaching to the guardian of a school-age child with cystic fibrosis. Which statement should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day.
• B. You should decrease your child's dietary fat intake to less than 10% of their caloric intake.
• C. You should restrict your child's calorie intake to 1,200 per day.
• D. You should give your child a multivitamin once weekly.

Correct answer: A

Rationale: The correct answer is A. High-protein meals and snacks are essential for children with cystic fibrosis due to their increased nutritional needs. Protein helps in maintaining muscle mass and overall health in individuals with cystic fibrosis, making it crucial to include in their diet. Choices B, C, and D are incorrect because decreasing dietary fat intake to less than 10% of caloric intake, restricting calorie intake to 1,200 per day, and giving a multivitamin once weekly are not appropriate dietary recommendations for a child with cystic fibrosis.

5. In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?

• A. An 8-year-old experiencing diarrhea
• B. A 2-year-old with a history of pre-term birth
• C. A 4-year-old with a fever and upper respiratory tract infection
• D. A 6-year-old who has been recently exposed to a classmate with chickenpox

Correct answer: C

Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.

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