Nursing Elites

1. A caregiver is seeking guidance from a healthcare provider concerning a child diagnosed with impetigo. Which of the following instructions should the healthcare provider include?

• A. Apply warm compresses to the affected area.
• B. Keep the child home from school until lesions are crusted over.
• C. Apply antibiotic ointment to the lesions.
• D. Cleanse the affected area with hydrogen peroxide.

Correct answer: C

Rationale: The healthcare provider should recommend applying antibiotic ointment to the lesions to prevent the spread of infection and facilitate healing. Antibiotic ointment helps combat the bacterial infection associated with impetigo and supports the skin's recovery process. This approach aids in reducing symptoms, preventing complications, and promoting a quicker resolution of the condition.

2. Following a child's return from exploratory surgery due to a gunshot wound to the abdomen, which nursing intervention should be excluded from the plan of care?

• A. Immediate initiation of oral feedings
• B. Assessment of the surgical site
• C. Administration of opioid narcotics for pain management
• D. Visitation at the bedside

Correct answer: A

Rationale: Immediate initiation of oral feedings should be excluded from the plan of care post-abdominal surgery due to the risk of bowel complications like paralytic ileus or anastomotic leak. Starting oral feedings immediately can increase these risks and hinder healing. It is crucial to wait until bowel function returns and the patient shows signs of tolerance before introducing oral feedings. Assessment of the surgical site is necessary to monitor for any signs of infection or complications. Administration of opioid narcotics for pain management is essential for ensuring the patient's comfort post-surgery. Visitation at the bedside provides emotional support and can aid in the patient's recovery. Therefore, the correct answer is to exclude immediate initiation of oral feedings.

3. A child is being assessed for acute poststreptococcal glomerulonephritis (APSGN). Which of the following findings should the nurse expect?

• A. Hematuria
• B. Polyuria
• C. Hypertension
• D. Diarrhea

Correct answer: C

Rationale: In acute poststreptococcal glomerulonephritis (APSGN), hypertension is a common finding due to fluid retention and decreased kidney function. This condition often presents with hypertension as a result of sodium and water retention, as well as reduced glomerular filtration rate. Hematuria, not diarrhea, is also a common symptom of APSGN due to inflammation and damage to the glomeruli. Polyuria, an increase in urine output, is not a typical finding in APSGN unless severe kidney damage leads to decreased urine concentrating ability.

4. While caring for four different pediatric clients, which child is at the highest risk for dehydration?

• A. 7-year-old child with migraine headaches
• B. 4-year-old child with a broken arm
• C. 2-year-old child with cellulitis of the left leg
• D. 18-month-old child with tachypnea

Correct answer: D

Rationale: The 18-month-old child with tachypnea is at the highest risk for dehydration due to increased insensible water loss associated with rapid breathing.

5. A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer?

• A. Aspirin
• B. Acetaminophen
• C. Ibuprofen
• D. Naproxen Sodium (Aleve)

Correct answer: B

Rationale: When a patient is already receiving glucocorticoids for rheumatoid arthritis and complains of a headache, it is essential to consider the potential interactions and side effects of additional medications. Aspirin and NSAIDs like ibuprofen and naproxen sodium can increase the risk of gastrointestinal irritation and ulceration when used concurrently with glucocorticoids. Acetaminophen is a safer choice in this scenario for managing the patient's headache without exacerbating the gastrointestinal issues associated with the use of glucocorticoids. Acetaminophen does not have the same gastrointestinal side effects as aspirin, ibuprofen, or naproxen sodium, making it the most appropriate option for headache relief in this case.

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