Nursing Elites

1. When teaching a parent of a toddler with congenital heart disease, which of the following instructions should the nurse include?

• A. Offer small, frequent meals.
• B. Limit the toddler's physical activity.
• C. Provide a low-sodium diet.
• D. Monitor the toddler's intake and output.

Correct answer: A

Rationale: The correct instruction for a parent of a toddler with congenital heart disease is to offer small, frequent meals. This recommendation helps reduce the cardiac workload on the child's heart and supports easier digestion and nutrient absorption, promoting the child's overall health. Limiting physical activity (choice B) may be necessary but is not the priority in this case. While offering a low-sodium diet (choice C) can be beneficial, it is not the most critical instruction. Monitoring the toddler's intake and output (choice D) is important but not as essential as providing small, frequent meals to support the child's heart health.

2. A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

• A. You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing.
• B. You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy.
• C. Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy.
• D. When using the peak expiratory flow meter, record your child's average of three readings.

Correct answer: C

Rationale: The nurse should inform the parent that the child will need pulmonary function tests every 12 to 24 months to assess lung function and response to treatment. These tests help evaluate the presence of lung disease, monitor disease progression, and assess the effectiveness of the current therapeutic regimen in managing asthma. Choice A is incorrect as salmeterol is not used for acute wheezing episodes but rather for long-term maintenance. Choice B is incorrect because weight monitoring is not directly related to inhaled corticosteroid therapy for asthma. Choice D is incorrect as peak expiratory flow meter readings should be recorded as instructed, not averaged.

3. The caregiver is providing care to a pediatric client diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which caregiver statement regarding administration of this drug indicates correct understanding of the teaching provided by the healthcare provider?

• A. I will administer this medication between meals.
• B. I will administer this medication at bedtime.
• C. I will administer this medication one hour before meals.
• D. I will administer this medication with meals.

Correct answer: D

Rationale: The correct answer is D. Prednisone should be administered with meals to reduce gastrointestinal upset. Taking prednisone with food helps to minimize stomach irritation and other gastrointestinal side effects associated with the medication.

4. A caregiver is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching?

• A. I should secure the car seat using lower anchors and tethers instead of the seat belt
• B. I should position the car seat harness one inch above my baby's shoulders
• C. I will make sure that the car seat is placed at a 90-degree angle
• D. I will pad my baby's car seat with a blanket for traveling long distances

Correct answer: A

Rationale: The correct answer is A. Lower anchors and tethers, known as the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides a safer and more secure way of installing the car seat compared to using the seat belt alone. Using the lower anchors and tethers ensures proper installation and reduces the risk of car seat movement during travel, providing optimal protection for the infant. Choices B, C, and D are incorrect. Choice B is incorrect because the car seat harness should be positioned at or below the baby's shoulders, not above. Choice C is incorrect because the car seat should be positioned at the correct recline angle recommended by the car seat manufacturer, which may not necessarily be 90 degrees. Choice D is incorrect because adding padding like a blanket to the car seat is not recommended as it can interfere with the proper fit and function of the car seat, potentially compromising the safety of the infant.

5. A healthcare professional is performing hearing screenings for children at a community health fair. Which of the following children should the professional refer to a provider for a more extensive hearing evaluation?

• A. A toddler who is 18 months old and has unintelligible speech
• B. An infant who is 3 months old and has an exaggerated startle response
• C. A preschooler who is 4 years old and prefers playing with others rather than alone
• D. An infant who is 8 months old and is not yet making babbling sounds

Correct answer: D

Rationale: The healthcare professional should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a more extensive evaluation of hearing. Babbling sounds are a developmental milestone that typically occurs by 7 months of age. Delayed or absent babbling can indicate potential hearing issues that warrant further assessment.

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