Nursing Elites

1. Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?

• A. If your blood glucose levels are controlled, you can switch to using pills.
• B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
• C. Your body does not make insulin, so the insulin injections help to replace it.
• D. The pills work on the adult pancreas; you can switch when you are 18.

Correct answer: C

Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.

2. After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should:

• A. assess for a carotid pulse.
• B. open the airway and ventilate.
• C. immediately perform CPR.
• D. reanalyze the cardiac rhythm.

Correct answer: C

Rationale: After delivering a shock, it is crucial to immediately resume CPR. CPR helps circulate oxygenated blood to vital organs until the AED prompts you to stop for further rhythm analysis. This continuous cycle of CPR and defibrillation maximizes the chances of restoring a normal cardiac rhythm and improving the child's chances of survival. Assessing for a carotid pulse is not necessary after a shock as pulse checks are often unreliable during resuscitation. Opening the airway and ventilating is not the immediate step after delivering a shock as CPR takes precedence. Reanalyzing the cardiac rhythm should be done only when prompted by the AED after a set period of CPR.

3. Which of the following is MOST likely to occur in conjunction with a breech presentation?

• A. Vertex presentation
• B. Maternal hypertension
• C. Prolapsed umbilical cord
• D. Premature rupture of the amniotic sac

Correct answer: C

Rationale: In a breech presentation, where the baby's buttocks or feet present first, there is an increased risk of the umbilical cord slipping down alongside or below the presenting part, leading to a prolapsed umbilical cord. This is a serious complication that can compromise fetal blood flow and oxygenation, necessitating prompt intervention to prevent adverse outcomes. Choices A, B, and D are less likely to occur in conjunction with a breech presentation. Vertex presentation is the normal head-first presentation, maternal hypertension is a separate condition that may not be directly related to fetal presentation, and premature rupture of the amniotic sac can happen independently of the baby's presentation.

4. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

• A. Give the child honey (simple sugar)
• B. Give the child milk (complex sugar)
• C. Contact the healthcare provider before doing anything
• D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

5. Based on the complaints provided by Madam KK, is the child exhibiting danger signs?

• A. Yes
• B. No
• C. I don't know
• D. Yes

Correct answer: A

Rationale: Yes, the child is displaying danger signs with symptoms such as fever and rapid breathing, indicating a potential serious health issue that requires immediate attention. The correct answer is 'Yes' because the symptoms described in Madam KK's complaints align with danger signs that suggest a severe health problem. Choices B and C are incorrect because the symptoms mentioned clearly indicate the presence of danger signs. Choice D is a duplicate of choice A and does not provide a valid alternative.

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