Nursing Elites

1. When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school’s Parent-Teachers Association?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.

2. In an adolescent suspected of having type 1 diabetes mellitus, which clinical manifestation may be present?

• A. moist skin
• B. weight gain
• C. fluid overload
• D. poor wound healing

Correct answer: D

Rationale: Poor wound healing is a common clinical manifestation of type 1 diabetes mellitus. Elevated blood glucose levels in diabetes can lead to impaired wound healing by affecting various cellular processes involved in the healing cascade. Moist skin (Choice A) is not typically associated with type 1 diabetes mellitus. Weight gain (Choice B) is more commonly seen in type 2 diabetes due to insulin resistance. Fluid overload (Choice C) is not a typical clinical manifestation of type 1 diabetes mellitus. Therefore, the correct answer is poor wound healing.

3. Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?

• A. Maintaining electrolyte balance
• B. Preventing dehydration
• C. Preventing fluid overload
• D. Avoiding cardiac overload

Correct answer: C

Rationale: In infants, monitoring IV flow rates is essential to prevent fluid overload, not cardiac overload. Excessive fluid administration can lead to complications such as pulmonary edema or congestive heart failure. It is crucial to maintain a balance between providing adequate hydration and avoiding fluid overload to prevent adverse outcomes. Options A, B, and D are incorrect because the primary concern is to prevent complications related to excess fluid rather than focusing on electrolyte balance, dehydration prevention, or avoiding cardiac overload.

4. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Eating meals at home is recommended.
• B. Food portions should be measured using a gram scale.
• C. Ensure a ready source of glucose is available.
• D. No specific foods need to be cooked for the adolescent.

Correct answer: C

Rationale: When teaching an adolescent with type 1 diabetes about dietary management, it is crucial to ensure a ready source of glucose is available. In cases of hypoglycemia, having a quick source of glucose can help raise blood sugar levels rapidly. Option A is not the most critical aspect of dietary management for an adolescent with type 1 diabetes. While it is generally recommended to eat meals at home for better control over food choices, the availability of a ready glucose source takes precedence. Option B, weighing foods on a gram scale, may not be practical for every meal and could be burdensome. Option D, cooking specific foods for the adolescent, is not necessary as the focus should be on the overall dietary plan rather than individualized meals.

5. A 7-year-old child with a history of seizures is being discharged from the hospital. What should the nurse include in the discharge teaching for the parents?

• A. Administer antiepileptic medication as prescribed, not just when a seizure occurs
• B. Ensure the child gets adequate sleep
• C. Restrict the child's activities to prevent seizures
• D. Teach seizure first aid to family members

Correct answer: D

Rationale: The correct answer is to teach seizure first aid to family members. This is crucial because family members need to know how to appropriately respond during a seizure to ensure the child's safety. Choice A has been corrected to emphasize that antiepileptic medication should be administered as prescribed, not just when a seizure occurs, to effectively manage the condition. Choice B, while important for overall health, is not directly related to seizure management. Choice C is not recommended as restricting activities may not prevent seizures and may hinder the child's quality of life.

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