Nursing Elites

1. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

2. The nurse is preparing to complete documentation on a patient's chart. Which should be included in documentation of nursing care? (Select all that apply.)

• A. Reassessments
• B. Nursing care provided
• C. Initial assessments
• D. All of the above

Correct answer: D

Rationale: Proper documentation includes reassessments, initial assessments, care provided, and the patient's response, but incident reports are typically documented separately.

3. The nurse is teaching parents about diarrhea in young children. A parent asks the nurse what causes most cases of diarrhea in young children. How should the nurse respond?

• A. Rotavirus
• B. Giardia
• C. Shigella
• D. Salmonella

Correct answer: A

Rationale: Rotavirus is the most common cause of diarrhea in young children, particularly those under the age of 2. Giardia, Shigella, and Salmonella can also cause diarrhea, but in the context of young children, Rotavirus is the primary pathogen responsible for diarrheal illnesses.

4. Where in the health history does a record of immunizations belong?

• A. History
• B. Present illness
• C. Review of systems
• D. Physical assessment

Correct answer: A

Rationale: Immunizations are part of the patient’s health history and are recorded under the history section to ensure the child is up-to-date with vaccinations.

5. The nurse is caring for a child with the following order: Methylprednisolone (Solu-Medrol) 20 mg IV, every 6 hours. The nurse has Methylprednisolone 100 mg in 2 mL available. How many mL should the nurse administer with each dose?

• A. 0.4 mL
• B. 0.2 mL
• C. 0.5 mL
• D. 0.6 mL

Correct answer: A

Rationale: The correct dosage to administer 20 mg is 0.4 mL, calculated by dividing the dose (20 mg) by the concentration (100 mg in 2 mL). This calculation ensures the accurate administration of the prescribed medication. Choices B, C, and D are incorrect as they do not reflect the correct calculation based on the provided concentration of the medication.

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