Nursing Elites

1. A 10-year-old child is being discharged after being admitted for status asthmaticus. Which instruction is most important for the nurse to include in the discharge teaching?

• A. Use a peak flow meter daily to monitor asthma control
• B. Avoid exposure to known allergens
• C. Continue taking asthma medications as prescribed
• D. Seek emergency care if symptoms worsen

Correct answer: A

Rationale: Using a peak flow meter daily is crucial as it helps monitor asthma control by measuring how well the child's lungs are functioning. This monitoring can indicate when intervention is needed before symptoms worsen or become severe, allowing for timely management of asthma exacerbations.

2. What action should the nurse implement when the infusion of chemotherapy via an implanted medication port is complete for a 16-year-old with acute myelocytic leukemia at the outpatient oncology clinic?

• A. Administer Zofran
• B. Obtain blood samples for RBCs, WBCs, and platelets
• C. Flush mediport with saline and heparin solution
• D. Initiate an infusion of normal saline

Correct answer: C

Rationale: The correct action for the nurse to implement when the chemotherapy infusion is complete is to flush the mediport with saline and heparin solution. This process helps prevent clotting and ensures the patency of the port, which is essential for future medication administrations and blood draws. Administering Zofran (Choice A) is not necessary after completing the chemotherapy infusion. Obtaining blood samples (Choice B) for RBCs, WBCs, and platelets is important but not the immediate action after completing the infusion. Initiating an infusion of normal saline (Choice D) is not required unless there is a specific indication for it.

3. The parents of a 4-year-old child who has just been diagnosed with celiac disease are being educated by a healthcare provider. Which statement by the parents indicates a correct understanding of the condition?

• A. We can give our child small amounts of gluten occasionally
• B. We need to avoid giving our child foods containing wheat, barley, and rye
• C. We should limit our child’s intake of dairy products
• D. Our child will need to take gluten-free supplements

Correct answer: B

Rationale: Choice B is the correct answer because for individuals with celiac disease, a strict gluten-free diet is essential for managing the condition. Foods containing wheat, barley, and rye must be completely avoided to prevent adverse reactions and damage to the intestines. This dietary restriction is crucial to ensure the child's health and well-being in managing celiac disease effectively. Choices A, C, and D are incorrect because giving small amounts of gluten occasionally, limiting dairy products, or taking gluten-free supplements are not sufficient measures to manage celiac disease. Complete avoidance of gluten-containing foods is necessary to prevent complications.

4. During a routine physical exam, a male adolescent client tells the nurse, 'sometimes, my mother gets angry because I want to be with my own friends.' What is the best initial response by the nurse?

• A. Offer reassurance that his mother's concern is normal
• B. Determine if his friends are engaged in unsafe behaviors
• C. Ask about the client's response to his mother's anger
• D. Offer to discuss his concerns with his mother

Correct answer: C

Rationale: When a client expresses concerns about family dynamics, it is important to explore their feelings and reactions to the situation. By asking about the client's response to his mother's anger, the nurse can gain insight into the client's emotions, thoughts, and coping mechanisms. Understanding these aspects is crucial in providing appropriate support and guidance. Option A is incorrect because it focuses solely on reassuring the client about his mother's concern without addressing the client's feelings. Option B assumes negative behaviors without evidence. Option D jumps to discussing concerns with the mother without understanding the client's perspective first.

5. The healthcare provider is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?

• A. Laughs readily, turns from back to side.
• B. Has strong Moro and tonic neck reflexes.
• C. Keeps fists clenched, opens hands when grasping an object.
• D. Can lift head, but not chest when lying on abdomen.

Correct answer: A

Rationale: The ability to laugh readily and turn from back to side indicates the effectiveness of thyroid therapy and normal development in a 5-month-old. These behaviors suggest improved muscle tone and motor skills, which are positive outcomes of thyroid hormone replacement therapy for hypothyroidism. Choices B, C, and D describe developmental milestones that are not specific indicators of the effectiveness of thyroid therapy in treating hypothyroidism in a 5-month-old.

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