Nursing Elites

1. The parents of a 5-year-old child, recently diagnosed with celiac disease, are being educated by the healthcare provider. Which statement by the parents indicates a need for further teaching?

• A. We need to avoid giving our child any foods that contain wheat, barley, or rye
• B. Our child can still eat oats as long as they are labeled gluten-free
• C. We should read food labels carefully to check for hidden sources of gluten
• D. It’s okay for our child to have small amounts of gluten occasionally

Correct answer: D

Rationale: The correct answer is D. Children with celiac disease must strictly adhere to a gluten-free diet. Even small amounts of gluten can cause harm by triggering an immune response that damages the intestines. It is crucial for parents to understand that allowing their child to have small amounts of gluten occasionally is not safe and can lead to complications. Therefore, further teaching is needed to emphasize the importance of complete avoidance of gluten-containing foods for a child with celiac disease. Choices A, B, and C demonstrate understanding of the need to avoid gluten-containing foods and hidden sources of gluten, which are essential in managing celiac disease. Choice D is incorrect as it suggests a lax approach to the child's diet, which can be harmful in the case of celiac disease.

2. When caring for a 4-year-old child diagnosed with celiac disease, the parent asks about foods to avoid. Which response by the nurse is correct?

• A. Avoid all dairy products
• B. Avoid foods containing wheat, barley, and rye
• C. Avoid all foods high in sugar
• D. Avoid foods with artificial coloring

Correct answer: B

Rationale: Celiac disease is managed with a strict gluten-free diet, necessitating the avoidance of foods containing wheat, barley, and rye. Gluten is found in these grains and can trigger an immune response in individuals with celiac disease, leading to damage to the small intestine. Therefore, it is essential for individuals with celiac disease, including children, to carefully avoid gluten-containing foods to maintain their health and well-being.

3. A 16-year-old male client who has been treated in the past for a seizure disorder is admitted to the hospital. Immediately after admission, he begins to have a grand mal seizure. Which action should the nurse take?

• A. Obtain assistance in holding him to prevent injury.
• B. Observe him carefully.
• C. Call a CODE.
• D. Place a padded tongue blade between the teeth.

Correct answer: B

Rationale: During a grand mal seizure, the priority action for the nurse is to ensure the safety of the client. Observing the client carefully allows the nurse to monitor the seizure activity, the client's breathing, and any signs of distress without interfering with the seizure process. Restraining the client or placing objects in the mouth can lead to injury and should be avoided. Calling a CODE is not appropriate for a seizure as it is a normal response to the client's condition.

4. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents?

• A. Permanent lifestyle changes need to be made to promote safety in the home
• B. The chorea or movements are temporary and will eventually disappear
• C. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged
• D. Consistent discipline is needed to help the child control the movements

Correct answer: C

Rationale: Chorea associated with rheumatic fever is usually temporary and will subside over time.

5. A 2-year-old boy begins to cry when the mother starts to leave. What is the nurse's best response in this situation?

• A. Let me read this book to you.
• B. Two years old usually stop crying the minute the parent leaves.
• C. Now be a big boy. Mommy will be back soon.
• D. Let's wave bye-bye to mommy.

Correct answer: D

Rationale: Waving bye-bye to mommy helps the child understand that the separation is temporary.

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