Nursing Elites

1. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?

• A. Ibuprofen, an anti-inflammatory agent
• B. Furosemide (Lasix), a diuretic
• C. Ciprofloxacin (Cipro), an antibiotic
• D. Cyclophosphamide (Cytoxan), an immunosuppressant

Correct answer: B

Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.

2. The healthcare provider is providing care to a child who was treated with aspirin during a viral infection. Which clinical manifestations should cause the healthcare provider concern?

• A. Nausea, vomiting, and confusion
• B. Headache, vomiting, and seizures
• C. Sore throat, moist respirations, and cough
• D. Fever, rash, and photophobia

Correct answer: A

Rationale: The symptoms of nausea, vomiting, and confusion are concerning as they are indicative of Reye's syndrome, a rare but serious condition associated with aspirin use in children during viral illnesses. Reye's syndrome can lead to severe complications, including brain and liver damage, hence prompt recognition and management are crucial.

3. The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?

• A. Analyze HR and rhythm
• B. Assess for Homan�s sign
• C. Check BP
• D. Palpate the pedal pulses

Correct answer: A

Rationale: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60 bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.

4. Which standardized test would be most appropriate for assessing the motor development of a 2-month-old infant in a high-risk clinic?

• A. Peabody Developmental Motor Scale (PDMS-2)
• B. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
• C. Pediatric Evaluation of Disability Index (PEDI)
• D. School Assessment of Motor and Process Skills (School-AMPS)

Correct answer: A

Rationale: The Peabody Developmental Motor Scale (PDMS-2) is specifically designed to assess the motor development of infants and young children, making it the most appropriate choice for evaluating a 2-month-old infant in a high-risk clinic setting.

5. A teacher states to the school nurse, 'I have a student who will often just stare at me for 15 seconds after asking a question; then the student blinks and asks me to repeat the question. Should I be concerned?' Which should the nurse include in the response to the teacher?

• A. The child has a crush on the teacher.
• B. The child has increased intracranial pressure.
• C. The child may have had a head injury.
• D. The child is experiencing absence seizures.

Correct answer: D

Rationale: Staring spells that end abruptly and are followed by normal activity are indicative of absence seizures. In absence seizures, a child may exhibit staring spells, brief loss of awareness, and lack of responsiveness, which can last for a few seconds. Choice A is incorrect because the behavior described is not associated with having a crush. Choice B is incorrect as increased intracranial pressure usually presents with other symptoms. Choice C is less likely as a head injury would typically manifest with additional signs beyond just staring and blinking.

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