Nursing Elites

1. The healthcare provider is caring for a 3-year-old child who is hospitalized with dehydration. The child is now receiving IV fluids and has started to produce urine. What is the best indicator that the child’s dehydration is improving?

• A. The child’s urine output has increased
• B. The child’s skin turgor is normal
• C. The child’s weight has increased
• D. The child’s vital signs are stable

Correct answer: A

Rationale: An increase in urine output is a reliable indicator that the child's hydration status is improving. Adequate urine output signifies that the kidneys are functioning properly and that the body is effectively eliminating waste and excess fluids, indicating improved hydration levels. The other options are not as direct indicators of hydration status. Skin turgor and weight changes can be influenced by various factors, and stable vital signs do not specifically reflect hydration status.

2. When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents?

• A. High protein.
• B. Low sodium.
• C. Low fat.
• D. High carbohydrate.

Correct answer: B

Rationale: The correct diet that the practical nurse should reinforce with the parents of a child with nephrotic syndrome is a low-sodium diet. This diet is crucial for managing fluid retention and reducing the risk of edema, which are common concerns in children with nephrotic syndrome.

3. Which nursing intervention is most important to assist in detecting hypopituitarism and hyperpituitarism in children?

• A. Carefully recording the height and weight of children to detect inappropriate growth.
• B. Performing head circumference measurements on infants under one year of age.
• C. Assessing for behavioral problems at home and school by interviewing the parents.
• D. Noting tracked weight gain without a gain in height on a growth chart.

Correct answer: A

Rationale: Recording the height and weight of children is crucial in detecting growth abnormalities like hypopituitarism and hyperpituitarism. Inappropriate growth patterns, such as disproportionate weight gain or stunted height, can be indicative of these conditions. Regular monitoring of height and weight is a fundamental nursing intervention that can aid in the early identification and management of pituitary-related disorders in children.

4. The caregiver is being educated by a healthcare provider about the use of a metered-dose inhaler (MDI) for their 8-year-old child with asthma. Which statement by the caregiver indicates a need for further teaching?

• A. I will shake the inhaler before each use
• B. My child should breathe in quickly after pressing the inhaler
• C. I should wait a minute between puffs
• D. We should use a spacer with the inhaler

Correct answer: B

Rationale: The caregiver should be informed that the child should breathe in slowly and deeply after pressing the inhaler. This allows for better medication delivery to the lungs and ensures optimal effectiveness of the treatment.

5. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?

• A. Induce vomiting using Ipecac to remove the corrosive agent.
• B. Administer vinegar or lemon juice to neutralize the caustic agent.
• C. Give activated charcoal to decontaminate the stomach.
• D. Telephone the poison control center and follow their advice.

Correct answer: D

Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.

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