Nursing Elites

1. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?

• A. 0.9% normal saline (NS)
• B.
• C. D5W
• D. Albumin

Correct answer: A

Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.

2. Which clean-catch urinalysis finding should raise the most concern for a child admitted to an urgent care center to rule out a urinary tract infection?

• A. 2+ white blood cells
• B. 1+ red blood cells
• C. Urine appearance: cloudy
• D. Specific gravity: 1.009

Correct answer: D

Rationale: A specific gravity of 1.009 is low, indicating diluted urine, which can be concerning in the context of a urinary tract infection. Diluted urine may suggest inadequate concentration due to increased fluid intake or impaired kidney function, which are important considerations in the assessment of a possible UTI.

3. When teaching a parent of a toddler with a new prescription for liquid ferrous sulfate, which of the following instructions should the nurse include?

• A. Mix the medication with milk.
• B. Give the medication with orange juice.
• C. Give the medication with meals.
• D. Administer the medication with an antacid.

Correct answer: B

Rationale: The correct answer is to give the medication with orange juice. Orange juice helps increase the absorption of iron from ferrous sulfate. This acidic environment aids in the absorption of iron, making it a suitable choice for administration. Mixing the medication with milk or an antacid may decrease iron absorption, and giving it with meals may not optimize its absorption as effectively as with orange juice.

4. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

• A. I will make sure he gets his measles vaccine as soon as he gets home.
• B. He can stop taking his medication next week.
• C. I should check his urine for protein when he goes to the bathroom.
• D. He should eat a low-protein diet for the next few weeks.

Correct answer: C

Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.

5. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?

• A. I should use a reliable form of birth control.
• B. I will stop taking the drug if my skin is dry.
• C. It is important to increase intake of vitamin A.
• D. I do not need to use sunblock while taking Accutane.

Correct answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.

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