Nursing Elites

1. The nurse is assessing a child with type 2 diabetes. The child is awake and alert with a serum glucose of 60 mg/dL. What action should the nurse take?

• A. Administer Insulin.
• B. Administer Epinephrine.
• C. Give 15 grams of carbohydrates.
• D. Give glucagon by injection.

Correct answer: C

Rationale: For a conscious child with mild hypoglycemia, giving 15 grams of fast-acting carbohydrates is the appropriate intervention. This can quickly raise blood glucose levels to prevent further complications. Administering insulin (Choice A) would further lower the glucose level, which is not suitable in this scenario. Administering epinephrine (Choice B) is not indicated for hypoglycemia. Glucagon (Choice D) is used for severe hypoglycemia with altered consciousness, not for mild cases where the child is awake and alert.

2. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?

• A. High serum pH
• B. Normal serum pH
• C. Metabolic alkalosis
• D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.

3. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?

• A. At bedtime
• B. With a meal
• C. Midmorning
• D. 30 minutes before breakfast

Correct answer: D

Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.

4. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?

• A. "We should watch for aggressive play."
• B. "Our child may show lasting symptoms of stress."
• C. "We know that our child will show caring behaviors."
• D. "Our child may have difficulty concentrating in school."

Correct answer: C

Rationale: Children exposed to chronic violence may struggle with stress and concentration but are less likely to consistently exhibit caring behaviors without intervention and support.

5. What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

• A. White rice
• B. Popcorn
• C. Fruit juice
• D. Ripe bananas

Correct answer: B

Rationale: Popcorn is a high-fiber food that can help manage chronic constipation in children. Other options like white rice and ripe bananas are low in fiber and less effective for treating constipation.

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