Nursing Elites

1. A 12-year-old child with type 1 diabetes is under the nurse's care. The child’s parent asks how to prevent hypoglycemia during physical activity. What is the nurse’s best response?

• A. Give your child extra insulin before exercise
• B. Make sure your child eats a snack before exercise
• C. Limit your child’s physical activity to avoid hypoglycemia
• D. Monitor your child’s blood glucose levels after exercise

Correct answer: B

Rationale: The most effective way to prevent hypoglycemia during physical activity in a child with type 1 diabetes is to ensure they eat a snack before exercising. Eating a snack before exercise helps maintain blood glucose levels by providing additional glucose for energy during physical activity, reducing the risk of hypoglycemia. Giving extra insulin before exercise (Choice A) can increase the risk of hypoglycemia as it lowers blood glucose levels further. Limiting physical activity (Choice C) is not recommended as exercise is important for overall health. Monitoring blood glucose levels after exercise (Choice D) is essential but does not directly prevent hypoglycemia during physical activity.

2. According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence?

• A. Guilt.
• B. Shame.
• C. Alienation.
• D. Inferiority.

Correct answer: D

Rationale: Erikson's theory of psychosocial development outlines that the failure to establish a sense of competence during the industry vs. inferiority stage results in feelings of inferiority. This stage occurs during middle childhood where children strive to master skills and tasks. If they are unable to meet challenges successfully, they may start feeling inferior to their peers and may lack confidence in their abilities. Choices A, B, and C are incorrect as guilt, shame, and alienation are not the specific behavioral patterns associated with the lack of developing a sense of competence according to Erikson's theory.

3. A 2-year-old girl is brought to the clinic by her 17-year-old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother?

• A. A 2-year-old should be speaking in 2-word phrases
• B. Dental caries is associated with drinking soda
• C. Drinking soda is related to childhood obesity
• D. Toddlers should be sleeping 10 hours a night

Correct answer: B

Rationale: Dental caries are a common concern when children consume sweetened sodas regularly.

4. A 3-year-old child is admitted to the hospital with severe dehydration. The healthcare provider prescribes an IV infusion of 0.9% normal saline. The nurse notes that the child’s heart rate is 150 beats per minute, and the blood pressure is 90/50 mm Hg. What should the nurse do first?

• A. Administer the IV fluids as prescribed
• B. Notify the healthcare provider
• C. Check the child’s urine output
• D. Reassess the child’s vital signs in 30 minutes

Correct answer: A

Rationale: In a pediatric patient with severe dehydration and signs of compromised hemodynamics such as tachycardia (heart rate of 150 bpm) and hypotension (blood pressure of 90/50 mm Hg), the priority intervention is to administer IV fluids as prescribed. Immediate fluid resuscitation is essential to restore hydration, improve perfusion, and stabilize the child's vital signs. While it's important to monitor urine output, initiating fluid resuscitation takes precedence in this situation. Notifying the healthcare provider can cause a delay in critical intervention, and waiting to reassess vital signs in 30 minutes can be detrimental in a child with severe dehydration and compromised hemodynamics.

5. Following a motor vehicle collision, a 3-year-old girl has a spica cast applied. Which toy is best for the nurse to offer this child?

• A. Duck that squeaks.
• B. Fashion doll and clothes.
• C. Set of cloth and hand puppets.
• D. Handheld video game.

Correct answer: C

Rationale: In this scenario, a set of cloth and hand puppets is the best choice for a 3-year-old with a spica cast. Hand puppets encourage imaginative play, creativity, and interaction, which are developmentally appropriate for a child of this age. The soft materials are safe for the child and can provide entertainment and engagement without posing a risk of injury. The other options, such as a duck that squeaks, a fashion doll and clothes, and a handheld video game, may not be as suitable for a child in a spica cast due to safety concerns, lack of interactive play, or developmental appropriateness.

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