Nursing Elites

1. As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas?

• A. Increased PCO2 and respiratory acidosis
• B. Decreased PCO2 and respiratory alkalosis
• C. Low pH and low PCO2
• D. High pH and high PCO2

Correct answer: A

Rationale: When a child's respirations are slow and shallow due to opioid administration, it results in hypoventilation. This leads to retaining carbon dioxide, indicated by an increased PCO2 level on arterial blood gas analysis, and subsequently causes respiratory acidosis due to the buildup of CO2 in the blood. Therefore, choice A, 'Increased PCO2 and respiratory acidosis,' is the correct answer. Choices B, C, and D are incorrect because slow and shallow respirations would not lead to decreased PCO2 or respiratory alkalosis (choice B), low pH and low PCO2 (choice C), or high pH and high PCO2 (choice D).

2. A parent of an infant with congenital hypothyroidism is receiving teaching from a nurse. Which of the following statements should the nurse include in the teaching?

• A. Your child will need to take medication for a few months
• B. You will need to give your child the medication every other day
• C. Your child will need to take the medication until age 10
• D. Your child will need to take the medication for life

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism requires lifelong medication to manage the condition effectively. The nurse should emphasize to the parent that their child will need to take the medication for life to ensure proper thyroid hormone levels and prevent complications associated with hypothyroidism.

3. The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

• A. Passive range-of-motion exercises to promote hip flexion
• B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
• C. Hourly vital signs and neurologic checks
• D. Elevate head of bed 30 degrees

Correct answer: A

Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.

4. Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?

• A. Bacteriuria and increased specific gravity
• B. Hematuria and proteinuria
• C. Proteinuria and decreased specific gravity
• D. Bacteriuria and hematuria

Correct answer: B

Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, the presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.

5. Which of the following is not considered a part of body language?

• A. Mannerisms
• B. Speech
• C. Posture
• D. Position

Correct answer: B

Rationale: Body language encompasses non-verbal communication cues such as mannerisms, posture, and position. Speech, although a form of communication, is not typically classified as part of body language. Body language mainly refers to gestures, facial expressions, and body movements, which convey messages non-verbally.

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