Nursing Elites

1. The nurse is caring for a 15-year-old adolescent who is admitted with a diagnosis of bulimia nervosa. The adolescent’s vital signs are stable, but the nurse notes that the client has dry skin and appears thin. What is the nurse’s priority action?

• A. Initiate a structured eating plan for the client
• B. Establish a therapeutic relationship with the client
• C. Monitor the client’s electrolyte levels
• D. Provide education on healthy eating habits

Correct answer: C

Rationale: In clients with bulimia nervosa, electrolyte imbalances are common due to purging behaviors and can lead to severe complications. Monitoring electrolyte levels is essential to detect and manage any imbalances promptly, as they can be life-threatening.

2. What information should the nurse provide the parents of a 3-year-old boy with Duchenne muscular dystrophy (DMD) who are concerned about having more children?

• A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family.
• B. The male infant had a viral infection that went unnoticed and untreated, leading to muscle damage.
• C. The mother's lack of the protein dystrophin can impact the XXXX muscle groups in males.
• D. Birth trauma during a breech vaginal birth can damage the spinal cord, resulting in muscle weakness.

Correct answer: A

Rationale: The correct answer is A. Duchenne muscular dystrophy is an inherited X-linked recessive disorder that primarily affects male children in the family. Since it is X-linked, sons inherit the mutation from their mothers who are carriers of the abnormal gene. Therefore, the nurse should explain to the parents that any future sons they have would have a 50% chance of inheriting the mutation and having DMD, while daughters would have a 50% chance of being carriers like the mother.

3. A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

• A. Place the child in a quiet environment
• B. Make a list of foods that the child likes
• C. Encourage the parents to rest when possible
• D. Apply lotion to hands and feet

Correct answer: A

Rationale: The correct intervention for a child with Kawasaki disease, presenting with irritability and skin peeling, is to place the child in a quiet environment. This helps reduce environmental stimuli, calming the child and aiding in managing the symptoms associated with the disease. Choice B is incorrect as addressing food preferences is not the priority in this situation. Choice C is incorrect as the focus should be on the child's immediate needs. Choice D is incorrect as applying lotion is not the first-line intervention for Kawasaki disease symptoms.

4. The healthcare provider is preparing to suture a 10-year-old child with a lacerated forehead. Both parents and a 12-year-old sibling are present at the child's bedside. Which instruction best supports family involvement?

• A. While waiting for the healthcare provider, only one visitor may stay with the child.
• B. All of you should leave while the healthcare provider sutures the child's forehead.
• C. It is best if the sibling goes to the waiting room until the suturing is completed.
• D. Please decide who will stay when the healthcare provider begins suturing.

Correct answer: D

Rationale: Involving the family members in deciding who will stay when the healthcare provider begins suturing supports family involvement and helps reduce anxiety for the child. This approach respects the family's dynamics and preferences, promoting a supportive environment during the procedure.

5. What recommendation should the PN provide to help a 5-year-old girl who has started wetting the bed again after being dry at night for several months?

• A. Explain that bedwetting is normal in children and will pass with time.
• B. Advise limiting fluids in the evening and before bedtime.
• C. Suggest punishing the child for wetting the bed to prevent recurrence.
• D. Encourage the child to use the bathroom immediately before bed.

Correct answer: D

Rationale: Encouraging the child to use the bathroom before bed is a helpful recommendation to prevent nighttime bedwetting. Bedwetting can sometimes reoccur due to stress or other factors, and ensuring the child empties their bladder before sleeping may reduce the likelihood of bedwetting episodes. Choice A is incorrect because while bedwetting is common in children, it is essential to provide practical solutions rather than just reassurance. Choice B is not the best option for a child who has recently started bedwetting again after being dry, as it may not address the underlying cause. Choice C is inappropriate and harmful as punishing the child for bedwetting can lead to psychological distress and worsen the situation.

Similar Questions