Nursing Elites

1. The healthcare professional is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: 4 oz of Pedialyte, One-half of an 8-oz cup of clear orange Jell-O, Two graham crackers, 200 mL of D5 1/2 sodium chloride IV. Output: 345 mL of urine, 50 mL of loose stool. How many milliliters should the healthcare professional document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

• A. 440
• B. 400
• C. 410
• D. 450

Correct answer: A

Rationale: The total intake is 440 mL (4 oz of Pedialyte = 120 mL, half of an 8 oz cup of Jell-O = 120 mL, and 200 mL of IV fluids). The graham crackers are not counted as intake. Therefore, the correct answer is 440. Choice B (400) is incorrect because it does not account for the intake of Jell-O. Choice C (410) is incorrect as it does not include the Pedialyte intake. Choice D (450) is incorrect because it overestimates the total intake by including the graham crackers.

2. Which medication is most likely to cause serious respiratory depression as a potential adverse reaction?

• A. Morphine
• B. Pentazocine
• C. Hydrocodone
• D. Nalmefene

Correct answer: A

Rationale: Morphine, as a strong opioid agonist, has the highest likelihood of causing serious respiratory depression due to its potent effects on the central nervous system. While Pentazocine and Hydrocodone can also cause respiratory depression, they are less likely to do so compared to morphine. Nalmefene, an opioid antagonist, is used to reverse respiratory depression caused by opioids rather than causing it.

3. Which parental statement indicates correct understanding of preventive techniques for heat-related illnesses when children exercise?

• A. Wearing dark clothing during exercise is not recommended.
• B. Water is the preferred fluid for fluid replenishment.
• C. During activity, stopping for fluids every 15 to 20 minutes is essential.
• D. Hydration should be maintained throughout the exercise session.

Correct answer: C

Rationale: The correct preventive technique for heat-related illnesses during exercise is to stop for fluids every 15 to 20 minutes to prevent dehydration and maintain hydration levels. This practice helps regulate body temperature and prevent heat-related complications. Choice A is incorrect as wearing light-colored, loose-fitting clothing is recommended to reflect sunlight and allow better air circulation. Choice B is incorrect as while water is important, a sports drink containing electrolytes may be more beneficial for longer exercise sessions. Choice D is incorrect as it does not emphasize the importance of regular fluid intake during exercise to prevent dehydration.

4. When educating a parent of an infant with a new prescription for digoxin, which instruction should the nurse provide?

• A. Repeat the dose if the infant vomits.
• B. Mix the medication with food.
• C. Give the medication with meals.
• D. Monitor the infant's heart rate prior to administering the medication.

Correct answer: D

Rationale: The correct answer is D: 'Monitor the infant's heart rate prior to administering the medication.' It is crucial for the nurse to monitor the infant's heart rate before giving digoxin to identify any signs of digoxin toxicity early. Heart rate assessment helps in detecting and preventing potential complications associated with digoxin use. Choices A, B, and C are incorrect. Repeating the dose if the infant vomits can lead to overdose, mixing the medication with food may alter its absorption, and giving the medication with meals can affect its effectiveness. Therefore, the priority is to monitor the infant's heart rate to ensure safe administration of digoxin.

5. Which physical assessment technique should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor?

• A. Performing range-of-motion exercises on lower extremities
• B. Palpating the abdomen
• C. Assessing for bowel sounds
• D. Percussing ankle and knee reflexes

Correct answer: B

Rationale: Palpating the abdomen should be omitted when caring for a 2-year-old child diagnosed with Wilms' tumor because it could disturb the tumor and potentially cause the malignancy to spread. The other assessment techniques are safe to perform and provide valuable information about the child's condition. Range-of-motion exercises help assess mobility and joint health, assessing for bowel sounds is important to monitor gastrointestinal function, and percussing ankle and knee reflexes can help evaluate neurological responses.

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