Nursing Elites

1. An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?

• A. Necrotizing enterocolitis (NEC)
• B. Ulcerative colitis (UC)
• C. Crohn's disease
• D. Appendicitis

Correct answer: B

Rationale: Ulcerative colitis is a type of inflammatory bowel disease characterized by recurrent abdominal pain, diarrhea, and bloody stools. The symptoms described align with the clinical presentation of ulcerative colitis, making it the most likely diagnosis in this scenario. Necrotizing enterocolitis primarily affects premature infants, Crohn's disease typically presents with non-bloody diarrhea, and appendicitis is characterized by right lower quadrant abdominal pain. Therefore, based on the symptoms provided, ulcerative colitis is the most appropriate suspicion.

2. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

3. Which food should be avoided by a child with acute glomerulonephritis to prevent hyperkalemia, as recommended by the nurse?

• A. Dairy products
• B. Whole-grain cereals
• C. Organ meats
• D. Bananas

Correct answer: D

Rationale: Bananas are rich in potassium, which can contribute to hyperkalemia in individuals with acute glomerulonephritis. It is essential to limit potassium intake to prevent further complications associated with high potassium levels in the blood.

4. A child with croup has an increased PCO2, a decreased pH, and a normal HCO3 blood gas value. Which finding does the nurse report to the healthcare provider based on these data?

• A. Uncompensated metabolic alkalosis
• B. Uncompensated metabolic acidosis
• C. Uncompensated respiratory acidosis
• D. Uncompensated respiratory alkalosis

Correct answer: C

Rationale: The blood gas values indicate uncompensated respiratory acidosis. In respiratory acidosis, there is an increased PCO2, decreased pH, and a normal HCO3 level. This condition requires immediate attention to address the underlying respiratory problem causing the acidosis.

5. A nurse is providing discharge teaching to the parent of a child who has juvenile idiopathic arthritis. Which of the following statements should the nurse include?

• A. Encourage the child to sleep for 8 hours each night.
• B. Perform range-of-motion exercises once per week.
• C. Give your child NSAIDs on a regular schedule.
• D. Apply heat to the child's affected joints twice daily.

Correct answer: C

Rationale: The nurse should instruct the parent to give the child NSAIDs on a regular schedule to maintain therapeutic levels and control pain.

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