Nursing Elites

1. After a discussion with the health care provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?

• A. The diameter of the aorta is enlarged.
• B. The wall between the right and left ventricles is open.
• C. It is a narrowing of the entrance to the pulmonary artery.
• D. It is a connection between the pulmonary artery and the aorta.

Correct answer: D

Rationale: The correct answer is D: 'It is a connection between the pulmonary artery and the aorta.' Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta, which normally closes after birth. Choices A, B, and C describe different cardiac conditions and do not accurately define PDA. Choice A is incorrect because PDA does not involve the diameter of the aorta being enlarged. Choice B is incorrect because PDA does not involve the wall between the right and left ventricles being open. Choice C is incorrect because PDA is not a narrowing of the entrance to the pulmonary artery.

2. The nurse is implementing care for a school-age child admitted to the pediatric intensive care unit with diabetic ketoacidosis (DKA). Which prescribed intervention should the nurse implement first?

• A. Begin 0.9% saline solution intravenously as prescribed
• B. Administer regular insulin intravenously as prescribed
• C. Place child on a cardiac monitor
• D. Place child on a pulse oximetry monitor

Correct answer: A

Rationale: Initiating intravenous saline solution is the initial priority in managing diabetic ketoacidosis to address dehydration and electrolyte imbalances. Administering insulin without addressing dehydration first can lead to potential complications. While monitoring cardiac status and oxygen saturation are important, addressing the fluid and electrolyte imbalances takes precedence in the management of DKA.

3. The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the nurse include as a major congenital anomaly?

• A. Overlapping digits
• B. Polydactyly
• C. Umbilical hernia
• D. Cleft palate

Correct answer: D

Rationale: Cleft palate is considered a major congenital anomaly because it involves a gap or split in the roof of the mouth, which can significantly impact feeding, speech development, dental health, and overall well-being. Overlapping digits (Choice A) and polydactyly (Choice B) are examples of limb abnormalities rather than major congenital anomalies affecting vital functions. Umbilical hernia (Choice C) is a common condition where abdominal organs protrude through the belly button and is typically not considered a major congenital anomaly in the same way as cleft palate.

4. 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.

5. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

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