Nursing Elites

1. When teaching a school-age child and the parent how to administer insulin, which of the following instructions should the nurse include?

• A. Store the insulin in the refrigerator after each use.
• B. Rotate injection sites each time you give the injection.
• C. You should give the insulin at room temperature.
• D. Administer the insulin within 30 minutes of each meal.

Correct answer: C

Rationale: It is essential to give insulin at room temperature to prevent discomfort during administration. Cold insulin can cause stinging and pain, which can be avoided by allowing the insulin to reach room temperature before administration. Storing insulin in the refrigerator is correct for long-term storage, but it should be brought to room temperature before use. Rotating injection sites is important to prevent lipohypertrophy, a condition characterized by fatty lumps that can develop if injections are consistently given in the same area. Administering insulin within 30 minutes of a meal is generally recommended to match the insulin peak action with the peak glucose levels after eating, but giving insulin at room temperature is more crucial to ensure comfort and proper absorption.

2. Which strategy is most likely to promote positive behavior in children?

• A. Providing flexible instructions with no consequences
• B. Limiting opportunities until the child performs adequately
• C. Improving the child's competence and creating a positive environment
• D. Setting strict rules with punishments for misbehavior

Correct answer: C

Rationale: Improving the child's competence and creating a positive environment is the most effective strategy to promote positive behavior in children. This approach focuses on enhancing the child's skills and abilities while fostering a supportive and encouraging atmosphere. By empowering the child and surrounding them with positivity, they are more likely to exhibit positive behaviors as they feel competent, valued, and motivated. This strategy emphasizes support and reinforcement over punitive measures, leading to long-lasting behavioral improvements.

3. What type of mode best describes Kasey's approach when meeting with the principal to change the cafeteria to better accommodate her client with difficulty eating in a noisy and distracting environment?

• A. Collaborating
• B. Instructing
• C. Advocating
• D. Encouraging

Correct answer: C

Rationale: Advocating best describes Kasey's approach in this scenario. Advocating involves presenting stories, research, and ideas to support and champion for a specific cause or individual, in this case, advocating for changes to better meet the child's needs in the cafeteria. Collaborating involves working together with others towards a common goal, instructing involves providing guidance or directions, and encouraging involves giving support or motivation, none of which fully capture Kasey's proactive and supportive advocacy actions in this context.

4. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?

• A. Offer Pedialyte between formula feedings.
• B. Feed the infant every 6 hours.
• C. Give diluted apple juice if the infant becomes dehydrated.
• D. Switch to soy-based formula permanently.

Correct answer: A

Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.

5. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

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