Nursing Elites

1. The healthcare provider notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. This is most likely the result of

• A. poor appetite
• B. increased potassium intake
• C. reduction of edema
• D. restriction to bed rest

Correct answer: C

Rationale: In acute glomerulonephritis, weight loss is most likely due to the reduction of edema. Edema is a common symptom of glomerulonephritis, which causes fluid retention and swelling in the body. As treatment progresses and the condition improves, the reduction of edema leads to weight loss. Choices A, B, and D are incorrect as they do not directly address the underlying pathophysiology of acute glomerulonephritis and its impact on weight loss.

2. What is one of the most important factors that a healthcare professional must consider when parents of a toddler request to be present at a procedure occurring on the hospital unit?

• A. Type of procedure to be performed
• B. Individual assessment of the parents
• C. Whether the toddler wants the parents present
• D. Probable reaction to the toddler’s response to pain

Correct answer: B

Rationale: When parents of a toddler request to be present during a procedure, an individual assessment of the parents is crucial. This assessment helps healthcare professionals understand the parents' ability to cope with the situation, provide support to their child, and ensure a conducive environment for the procedure. Choice A is not as critical because the focus is on the parents' readiness rather than the specific procedure. Choice C, considering the toddler's desire, is important but not as crucial as assessing the parents. Choice D, anticipating the toddler's response to pain, is relevant but secondary to assessing the parents' readiness and support capabilities.

3. You are managing a 10-month-old infant who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. You have initiated supplemental oxygen therapy and elevated the lower extremities. En route to the hospital, you note that the child's work of breathing has increased. What must you do first?

• A. Lower the extremities and reassess the child
• B. Begin positive pressure ventilations and reassess the child
• C. Place a nasopharyngeal airway and increase the oxygen flow
• D. Listen to the lungs with a stethoscope for abnormal breath sounds

Correct answer: A

Rationale: In this scenario, the infant is presenting with signs of respiratory distress, as evidenced by the increased work of breathing. Lowering the extremities can help reduce the workload on the diaphragm and improve respiratory mechanics. This action can be beneficial in optimizing the infant's breathing before considering more invasive interventions. Option B, initiating positive pressure ventilations, should be considered if the infant's condition deteriorates further and not as the first step. Option C, placing a nasopharyngeal airway and increasing oxygen flow, is not indicated as the primary intervention for increased work of breathing. Option D, listening to the lungs with a stethoscope, may provide additional information but is not the most urgent action needed in this situation.

4. A 6-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV). What should the nurse include in the care plan?

• A. Providing small, frequent feedings
• B. Administering antibiotics
• C. Maintaining strict isolation
• D. Elevating the head of the bed

Correct answer: D

Rationale: Elevating the head of the bed is essential in the care of an infant with RSV as it helps improve breathing by reducing congestion and promoting drainage. This position also aids in maintaining patent airways and can enhance comfort for the infant. Providing small, frequent feedings (Choice A) is generally appropriate for infants but is not a specific intervention for RSV. Administering antibiotics (Choice B) is not indicated for RSV, as it is a viral infection and antibiotics are ineffective against viruses. Maintaining strict isolation (Choice C) is important to prevent the spread of infections, but it is not a direct care intervention for managing RSV symptoms.

5. A 2-year-old child with a diagnosis of hemophilia is admitted to the hospital. What should the nurse include in the care plan?

• A. Encourage participation in contact sports
• B. Use a soft toothbrush for oral care
• C. Administer nonsteroidal anti-inflammatory drugs
• D. Administer aspirin for pain

Correct answer: B

Rationale: Using a soft toothbrush helps to prevent bleeding in a child with hemophilia.

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