Nursing Elites

1. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?

• A. A low-fiber diet is not always required.
• B. Stress management may be helpful.
• C. Milk products may or may not be a contributing factor.
• D. Pantoprazole (a proton pump inhibitor) is not a first-line treatment.

Correct answer: B

Rationale: The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.

2. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?

• A. Restlessness
• B. Distractibility
• C. Rectal discharge
• D. Intense perianal itching

Correct answer: D

Rationale: Intense perianal itching is the most common symptom of pinworm infection, especially at night when the female worms lay their eggs

3. The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)

• A. Hyponatremia
• B. Hyperkalemia
• C. All are applicable
• D. Elevated blood urea nitrogen level

Correct answer: C

Rationale: In acute renal failure, laboratory findings typically include hyperkalemia, hyponatremia, and elevated blood urea nitrogen (BUN) levels due to the kidneys' inability to excrete waste and balance electrolytes. Metabolic alkalosis is less common, with metabolic acidosis being more typical.

4. An appropriate method for administering oral medications that are bitter to an infant or small child should be to mix them with which?

• A. Bottle of formula or milk
• B. Any food the child is going to eat
• C. One teaspoon of something sweet-tasting such as jam
• D. Carbonated beverage, which is then poured over crushed ice

Correct answer: C

Rationale: Mixing bitter medication with a small amount of something sweet, like jam, can mask the taste effectively without diluting the medication too much. Mixing with milk or formula is not recommended as the child may refuse future feedings, and carbonated beverages are not suitable for infants.

5. The nurse is teaching parents guidelines for feeding their 8-month-old infant with failure to thrive (FTT). Which statement by the parents indicates a need for further teaching?

• A. We will continue to use the 24-kcal/oz formula.
• B. We will be sure to follow the formula preparation instructions.
• C. We will be sure to give our infant at least 8 oz of juice every day.
• D. We will be sure to feed our infant according to the written schedule.

Correct answer: C

Rationale: Providing 8 oz of juice daily is excessive for an 8-month-old infant and can displace other nutrient-rich foods or formulas that are necessary for growth, especially in an infant with FTT.

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