Nursing Elites

1. A nurse is providing dietary teaching to the parent of a school-age child with cystic fibrosis. Which of the following statements should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day
• B. Your child should decrease dietary fats to less than 10% of their caloric intake
• C. Your child will need to take a 1-gram sodium chloride tablet daily throughout their lifetime
• D. You should calculate your child's carbohydrate needs based on their daily activities

Correct answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis. Choices B, C, and D are incorrect because children with cystic fibrosis actually need a higher fat intake for proper absorption of fat-soluble vitamins, sodium chloride supplementation is not a general recommendation for all children with cystic fibrosis, and carbohydrate needs are usually based on maintaining adequate weight and growth rather than daily activities.

2. What does the abbreviation BPD mean in a medical chart?

• A. Brain premature deficit
• B. Bronchiopulmonary dysplasia
• C. Bilateral partial disorder
• D. Baby post delivery

Correct answer: B

Rationale: The correct answer is B: Bronchiopulmonary Dysplasia. BPD refers to a chronic lung disorder that primarily affects premature infants or those who have been on ventilator support. It is characterized by abnormal development of the lungs and breathing difficulties. This abbreviation is commonly seen on medical charts in neonatal and pediatric settings.

3. Which clinical manifestation should a nurse monitor for when assessing a pediatric client diagnosed with a basilar skull fracture?

• A. Periorbital ecchymosis
• B. Subdural hematoma
• C. Protruding bone
• D. Epidural hematoma

Correct answer: A

Rationale: Periorbital ecchymosis, also known as raccoon eyes, is a classic sign of a basilar skull fracture. It presents as bruising around the eyes due to blood collecting in the tissues. Monitoring for periorbital ecchymosis is crucial in assessing a pediatric client with a basilar skull fracture because it can indicate the presence of this serious injury.

4. During a home care visit for an infant diagnosed with gastroesophageal reflux, which parental action observed requires intervention by the nurse?

• A. The infant's formula is mixed with rice cereal.
• B. The mother positions the infant in a high Fowler position while feeding.
• C. After feeding, the infant is placed in a car seat.
• D. The mother administers ranitidine (Zantac) to the infant using a syringe.

Correct answer: C

Rationale: Placing an infant diagnosed with gastroesophageal reflux in a car seat after feeding can increase the risk of reflux and aspiration. The semi-upright or high Fowler position is recommended to help reduce reflux symptoms during feeding. Adding rice cereal to formula can help thicken it and reduce reflux episodes. Administering ranitidine using a syringe is a common method of oral medication administration. Therefore, the action of placing the infant in a car seat after feeding is the one that requires intervention due to the increased risk it poses.

5. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?

• A. My daughter should wash and wipe the perineal area from front to back.
• B. I am only going to have my daughter wear cotton underwear.
• C. It is acceptable to take frequent bubble baths.
• D. She needs to drink lots of fluids and void frequently.

Correct answer: C

Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.

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