Nursing Elites

1. Marge is a 2-year-old girl who does not sit and eat at mealtimes but rather brings food to many rooms, eats a few bites, and drops it. Her parents report that she is a 'fussy eater.' Marge is significantly below weight for her age. She does not have any oral motor structure abnormalities, but eats only certain foods with the same texture. Which intervention strategy would be best to address the environmental context?

• A. Prolong mealtimes and eliminate all snacks
• B. Provide high-calorie snacks and meals at the table throughout the day
• C. Allow Marge to eat whenever and wherever she wants in the house
• D. Require Marge to eat everything on her plate and at snack

Correct answer: B

Rationale: In the case of Marge, who exhibits selective eating habits and struggles with weight gain, providing high-calorie snacks and meals at the table throughout the day can be an effective intervention. This strategy can help increase her food intake in a structured environment, promoting healthier eating habits and potentially addressing her below-average weight status. Choice A, prolonging mealtimes and eliminating all snacks, may not be the best approach as it could lead to more food refusal and stress during meals. Choice C, allowing Marge to eat whenever and wherever she wants in the house, may further enable her selective eating behavior and hinder progress. Choice D, requiring Marge to eat everything on her plate and at snack, can create a negative mealtime environment and may not address the underlying causes of her eating habits. Therefore, providing high-calorie snacks and meals at designated times offers a balanced approach to support Marge's nutritional needs and overall well-being.

2. A child is being cared for by a nurse and has rheumatic fever. Which of the following actions should the nurse plan to take?

• A. Administer aspirin to the child as prescribed based on the healthcare provider's instructions.
• B. Encourage adequate fluid intake for the child.
• C. Elevate the child's joints and provide warm compresses.
• D. Monitor the child's heart rate for dysrhythmias.

Correct answer: D

Rationale: Rheumatic fever can lead to cardiac complications, such as dysrhythmias. Therefore, it is essential for the nurse to monitor the child's heart rate closely for any signs of dysrhythmias. This will help in early identification and prompt management of potential cardiac issues associated with rheumatic fever. Choices A, B, and C are not the priority actions in this scenario. While aspirin may be used in the treatment of rheumatic fever, monitoring for cardiac complications takes precedence. Encouraging fluid intake and providing warm compresses are helpful interventions but do not directly address the cardiac risks associated with rheumatic fever.

3. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

4. For a 6-year-old child with hypokalemia, which menu choice should the nurse encourage?

• A. Pizza with a fruit plate
• B. Chicken strips with chips
• C. Fajita with rice
• D. Hamburger with French fries

Correct answer: A

Rationale: Pizza with a fruit plate is the most suitable choice for a 6-year-old child with hypokalemia due to its potassium content. Potassium-rich foods like fruits can help replenish potassium levels in the body, aiding in the treatment of hypokalemia.

5. A parent of a child with cystic fibrosis is being taught about dietary guidelines. Which statement by the parent indicates an understanding of the teaching?

• A. My child should eat a high-calorie, high-protein diet.
• B. My child should avoid eating eggs.
• C. My child should follow a low-fat, low-sodium diet.
• D. My child should follow a high-fiber, high-protein diet.

Correct answer: A

Rationale: The correct answer is A. For a child with cystic fibrosis, a high-calorie, high-protein diet is recommended to meet the increased metabolic needs associated with the condition. The protein helps with growth and repair, while the extra calories help compensate for malabsorption and increased energy requirements. Choice B is incorrect because eggs are a good source of protein and essential nutrients unless the child has a specific allergy. Choice C is incorrect as a low-fat, low-sodium diet is not typically recommended for children with cystic fibrosis who need higher calorie and fat intake. Choice D is incorrect because while a high-protein diet is beneficial, a high-fiber diet may not be suitable for a child with cystic fibrosis due to potential gastrointestinal issues.

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