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. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist albuterol (Proventil). The child’s mother tells the nurse that she uses this medication to open her son’s airway when he is having trouble breathing. What is the nurse’s best response?

• A. Recommend that the mother bring the child in for immediate evaluation
• B. Advise the mother that overuse of the drug may cause chronic bronchitis
• C. Assure the mother that she is using the medication correctly
• D. Confirm that the medication helps to reduce airway inflammation

Correct answer: C

Rationale: The correct response is to assure the mother that she is using the medication correctly. Albuterol is a beta-adrenergic agonist that helps open the airways during an asthma attack. By reassuring the mother, the nurse reinforces the correct usage of the medication, which is crucial in managing the child's asthma symptoms effectively. Option A is incorrect because immediate evaluation may not be necessary if the child's symptoms are being managed effectively with albuterol. Option B is incorrect as chronic bronchitis is not typically associated with the overuse of albuterol. Option D is incorrect as albuterol primarily acts as a bronchodilator and does not directly reduce airway inflammation.

3. The healthcare provider is preparing to administer a vaccine to a 5-year-old child. The child is visibly anxious and asks if the shot will hurt. What is the healthcare provider’s best response?

• A. It might hurt a little, but it will be over quickly
• B. It won't hurt at all, don't worry
• C. You're a big kid now, and big kids don't cry
• D. If you don't think about it, it won't hurt

Correct answer: A

Rationale: When a child expresses fear or anxiety about receiving a vaccination, it is essential for the healthcare provider to provide honest and reassuring information. Choice A acknowledges the potential for some discomfort but also reassures the child that it will be over quickly. This response validates the child's feelings while also preparing them for the procedure. Choices B, C, and D either provide false reassurance, dismiss the child's feelings, or suggest avoidance, which are not appropriate responses in this situation.

4. What information should a nurse discuss with the mother of a 2-year-old girl who is drinking sweetened soda from her bottle?

• A. Encouraging 2-word phrases in speech development for a 2-year-old
• B. Explaining the association between drinking soda and dental caries
• C. Discussing the link between drinking soda and childhood obesity
• D. Emphasizing the importance of toddlers sleeping 10 hours a night

Correct answer: B

Rationale: The correct answer is explaining the association between drinking soda and dental caries. Soda consumption can lead to tooth decay and cavities, so it is crucial to educate the mother about this to prevent dental issues in the child.

5. A 10-year-old child is admitted to the hospital with a diagnosis of acute glomerulonephritis. The nurse notes that the child has edema and elevated blood pressure. What is the nurse’s priority action?

• A. Administer antihypertensive medication as prescribed
• B. Monitor the child’s urine output
• C. Elevate the child’s legs to reduce edema
• D. Restrict the child’s fluid intake

Correct answer: A

Rationale: In a child with acute glomerulonephritis presenting with edema and elevated blood pressure, the priority action for the nurse is to administer antihypertensive medication as prescribed. Managing blood pressure is essential to prevent further complications associated with the condition, such as worsening kidney function and cardiovascular strain. Monitoring urine output is important but not the priority over managing elevated blood pressure. Elevating the child's legs may help with edema but addressing the elevated blood pressure takes precedence. Fluid intake restriction may be necessary in some cases, but it is not the immediate priority when managing acute glomerulonephritis with edema and hypertension.

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