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. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

• A. 440
• B. 400
• C. 410
• D. 450

Correct answer: A

Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.

3. The nurse plans to closely monitor for which clinical manifestation after administering furosemide (Lasix)?

• A. Decrease pulse
• B. Decrease temperature
• C. Decrease BP
• D. Decrease respiratory rate.

Correct answer: C

Rationale: High-ceiling diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased BP. When BP drops, the pulse will probably increase rather than decrease.

4. 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.

5. 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.

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