Nursing Elites

1. The parents of a 10-year-old child with newly diagnosed type 1 diabetes are being taught by the nurse about managing their child’s condition. Which statement by the parents indicates they need further teaching?

• A. We should rotate injection sites to prevent tissue damage
• B. Our child should avoid all sugary foods and drinks
• C. We will monitor blood glucose levels regularly
• D. Our child needs to wear a medical alert bracelet

Correct answer: B

Rationale: It is important for individuals with diabetes to manage their carbohydrate intake, including sugary foods and drinks, rather than completely avoiding them. Sugary foods should be consumed in moderation as part of a balanced diet to help maintain stable blood glucose levels.

2. A 10-year-old child is admitted with diabetic ketoacidosis (DKA). Which laboratory value should the practical nurse (PN) anticipate?

• A. Elevated blood glucose.
• B. Decreased serum ketones.
• C. Low urine glucose.
• D. High bicarbonate levels.

Correct answer: A

Rationale: In a case of diabetic ketoacidosis (DKA), the primary feature is elevated blood glucose levels due to insulin deficiency. Additionally, ketones are increased in the blood and urine. Bicarbonate levels are usually low because of the metabolic acidosis that accompanies DKA. Therefore, the practical nurse should anticipate elevated blood glucose levels as a characteristic laboratory finding in a child admitted with DKA. Choice B is incorrect because serum ketones are increased in DKA. Choice C is incorrect because in DKA, urine glucose is typically high due to spillage of glucose into the urine. Choice D is incorrect because bicarbonate levels are usually low in DKA, not high.

3. A 2-year-old child with respiratory syncytial virus (RSV) is being treated in the hospital. What should the healthcare provider monitor for in this child?

• A. Increased urine output.
• B. Decreased respiratory rate.
• C. Labored breathing.
• D. Improved appetite.

Correct answer: C

Rationale: Labored breathing is a critical sign of worsening respiratory distress in children with RSV. It indicates that the child's condition may be deteriorating, requiring prompt intervention to ensure adequate oxygenation and prevent respiratory failure. Monitoring for labored breathing allows healthcare providers to promptly assess and manage the child's respiratory status, potentially preventing further complications associated with RSV infection.

4. The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take?

• A. Document the finding
• B. Palpate scrotum for testicular descent
• C. Assess for bladder distension
• D. Auscultate bowel sounds

Correct answer: A

Rationale: The correct action for the nurse to take in this situation is to document the finding. The infant voiding a urinary stream from the ventral surface of the penis suggests hypospadias, a condition where the urethral opening is on the underside of the penis. This finding is crucial information that needs to be documented for further evaluation. Palpating the scrotum for testicular descent, assessing for bladder distension, and auscultating bowel sounds are not appropriate actions based on the presented scenario and do not address the specific concern of the urinary stream location.

5. The healthcare provider is providing postoperative care to a 4-year-old child who underwent tonsillectomy. The provider notices that the child is frequently swallowing. What should the provider do first?

• A. Check the child’s throat for signs of bleeding
• B. Offer the child ice chips to soothe the throat
• C. Elevate the head of the child’s bed
• D. Administer prescribed pain medication

Correct answer: A

Rationale: Frequent swallowing after tonsillectomy may indicate bleeding, which requires immediate assessment and intervention. Checking the child’s throat for signs of bleeding is the priority to ensure timely identification and management of any potential bleeding complications.

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