Nursing Elites

1. The mother of an infant diagnosed with bronchiolitis asks the nurse what causes the disease. How should the nurse respond?

• A. Respiratory syncytial virus (RSV)
• B. Haemophilus influenzae
• C. Parainfluenza
• D. Rotavirus

Correct answer: A

Rationale: The correct answer is A: Respiratory syncytial virus (RSV). RSV is the most common cause of bronchiolitis, especially in infants. Bronchiolitis is characterized by inflammation of the small airways in the lungs. Choice B, Haemophilus influenzae, is a bacterium that can cause respiratory infections but is not the primary cause of bronchiolitis. Choice C, Parainfluenza, is a common viral infection that can cause croup and other respiratory illnesses but is not the main cause of bronchiolitis. Choice D, Rotavirus, is a virus that primarily affects the gastrointestinal system, causing diarrhea and vomiting, and is not associated with bronchiolitis.

2. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

• A. Postpone starting the IV until the next shift.
• B. Start the IV line and then allow for expression of feelings.
• C. Change the route of the antibiotics to PO.
• D. Postpone starting the IV line until the child is ready.

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

3. A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock?

• A. Restlessness
• B. Rapid capillary refill
• C. Increased temperature
• D. Increased blood pressure

Correct answer: A

Rationale: Restlessness is an early sign of shock due to decreased perfusion and oxygenation to the brain. This symptom requires immediate attention to prevent the progression to more severe stages of shock. Rapid capillary refill (Choice B) is not typically an early sign of shock but rather a sign of adequate perfusion. Increased temperature (Choice C) may occur in later stages of shock due to the body's response to stress. Increased blood pressure (Choice D) is not an early sign of shock; in fact, blood pressure tends to decrease in shock as a compensatory mechanism.

4. A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)

• A. Dialysis
• B. All below
• C. Sodium bicarbonate
• D. Glucose 50% and insulin

Correct answer: A

Rationale: Calcium gluconate, sodium bicarbonate, and glucose with insulin are used as temporary measures to rapidly reduce serum potassium levels. They help shift potassium into cells and stabilize the heart but do not remove potassium from the body like dialysis does.

5. Which food should be introduced first to a 6-month-old infant?

• A. Fruits
• B. Eggs
• C. Vegetables
• D. Meat

Correct answer: C

Rationale: Vegetables, particularly pureed ones, are often recommended as a first solid food for infants because they are easy to digest and less likely to cause allergies. Fruits can be introduced later due to their natural sweetness, while eggs and meat are typically introduced after fruits and vegetables as they may pose a higher risk of allergies.

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