Nursing Elites

1. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?

• A. Notifying the doctor immediately
• B. Applying ice
• C. Elevating the arm
• D. Giving additional pain medication as ordered

Correct answer: A

Rationale: The correct action would be to notify the doctor immediately. Unrelenting pain despite medication can indicate compartment syndrome, which is a medical emergency requiring immediate attention. Applying ice, elevating the arm, or giving additional pain medication may not address the underlying cause of the unrelenting pain, which could be a sign of a serious complication like compartment syndrome. Prompt medical evaluation is crucial in this situation to prevent potential complications.

2. A nurse is caring for an infant with phenylketonuria (PKU). What diet should the nurse anticipate will be ordered by the healthcare provider?

• A. Fat-free
• B. Protein-enriched
• C. Phenylalanine-free
• D. Low-phenylalanine

Correct answer: D

Rationale: A low-phenylalanine diet is necessary for infants with PKU because it helps prevent the accumulation of phenylalanine, which can result in brain damage. Fat-free (Choice A) and protein-enriched (Choice B) diets are not specifically indicated for PKU. While phenylalanine-free (Choice C) may seem logical, complete elimination of phenylalanine is not practical or safe as it is an essential amino acid. Therefore, the correct choice is a low-phenylalanine diet, which restricts phenylalanine intake to a safe level.

3. What would be important for the nurse to include when teaching an adolescent about tinea pedis?

• A. Keep your feet moist and exposed to the air as much as possible.
• B. Dry the area between your toes thoroughly.
• C. Wear nylon or synthetic socks every day.
• D. Walk barefoot in the school locker room.

Correct answer: B

Rationale: The correct answer is B: 'Dry the area between your toes thoroughly.' When educating an adolescent about tinea pedis, emphasis should be placed on keeping the feet dry, especially between the toes, to minimize the risk of fungal infection. Choice A is incorrect as keeping the feet moist can exacerbate the condition. Choice C is incorrect because nylon or synthetic socks can trap moisture, promoting fungal growth. Choice D is incorrect as walking barefoot in locker rooms increases the risk of contracting tinea pedis from contaminated surfaces.

4. A child with a diagnosis of asthma is being cared for by a nurse. What is an important nursing intervention?

• A. Administering bronchodilators
• B. Encouraging physical activity
• C. Monitoring oxygen saturation
• D. Providing nutritional support

Correct answer: A

Rationale: Administering bronchodilators is a crucial nursing intervention for a child with asthma because it helps to open the airways and ease breathing during an asthma attack. Bronchodilators are medications that work by relaxing the muscles around the airways, making it easier for the child to breathe. Encouraging physical activity may exacerbate asthma symptoms in some cases due to increased respiratory effort and exposure to triggers. Monitoring oxygen saturation is important but does not address the immediate need of opening the airways during an asthma episode. Providing nutritional support is essential for overall health but is not the primary intervention needed in managing an acute asthma exacerbation.

5. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?

• A. It limits the chance of vomiting.
• B. It allows the feeding to be administered rapidly.
• C. The energy that would have been expended on sucking is conserved.
• D. The quantity of nutritional liquid can be regulated better than with a bottle.

Correct answer: C

Rationale: Gavage feedings are necessary for infants with congenital heart defects to conserve the infant's energy by eliminating the need for sucking. This is important because sucking requires energy expenditure, which can be taxing for infants with cardiac defects. Choice A is incorrect as gavage feedings do not primarily limit the chance of vomiting. Choice B is incorrect because the speed of feeding administration is not the primary reason for using gavage feedings in this case. Choice D is incorrect as the regulation of the quantity of nutritional liquid is not the main purpose of gavage feedings in infants with congenital heart defects.

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