Nursing Elites

1. In the management of heart failure, which diuretic is preferred due to its demonstrated significant mortality reduction in patients with heart failure?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (HydroDIURIL)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: C

Rationale: Spironolactone, a potassium-sparing diuretic, is the preferred choice in heart failure due to its cardio-protective effect, leading to reduced mortality in patients with heart failure. It is used to manage both hypertension and edema, making it a valuable option in heart failure treatment.

2. Prior to hydrotherapy treatment for wound debridement following a burn injury, which of the following actions should be taken?

• A. Apply topical antimicrobial ointment to the child's wound
• B. Place a mesh gauze dressing over the child's wound
• C. Administer an analgesic to the child
• D. Initiate prophylactic antibiotic therapy for the child

Correct answer: C

Rationale: Corrected Rationale: Prior to hydrotherapy for wound debridement, it is crucial to administer an analgesic to the preschooler. The procedure is known to be extremely painful, and providing analgesia or sedation is essential to manage the discomfort and pain experienced by the child during the treatment. Choice A is incorrect because applying topical antimicrobial ointment is not a pre-procedural requirement but rather a post-procedure wound care step. Choice B is incorrect as placing a mesh gauze dressing does not address the pain management aspect. Choice D is also incorrect as prophylactic antibiotic therapy is not the primary intervention needed before hydrotherapy for wound debridement.

3. A parent of a child with cerebral palsy is being taught about home care by a healthcare provider. Which statement by the parent indicates an understanding of the teaching?

• A. I will perform range-of-motion exercises twice a day.
• B. I will apply a heating pad on my child's legs to reduce spasms.
• C. I will allow my child to rest in a recliner for 1 hour each day.
• D. I will use wrist splints to maintain alignment.

Correct answer: D

Rationale: Using wrist splints can help maintain alignment and prevent contractures in a child with cerebral palsy. This intervention is crucial in managing the condition and supporting the child's mobility and function.

4. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

5. A parent of a child with cystic fibrosis is being taught about dietary guidelines. Which statement by the parent indicates an understanding of the teaching?

• A. My child should eat a high-calorie, high-protein diet.
• B. My child should avoid eating eggs.
• C. My child should follow a low-fat, low-sodium diet.
• D. My child should follow a high-fiber, high-protein diet.

Correct answer: A

Rationale: The correct answer is A. For a child with cystic fibrosis, a high-calorie, high-protein diet is recommended to meet the increased metabolic needs associated with the condition. The protein helps with growth and repair, while the extra calories help compensate for malabsorption and increased energy requirements. Choice B is incorrect because eggs are a good source of protein and essential nutrients unless the child has a specific allergy. Choice C is incorrect as a low-fat, low-sodium diet is not typically recommended for children with cystic fibrosis who need higher calorie and fat intake. Choice D is incorrect because while a high-protein diet is beneficial, a high-fiber diet may not be suitable for a child with cystic fibrosis due to potential gastrointestinal issues.

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