Nursing Elites

1. What information should the nurse provide the parents of a 3-year-old boy with Duchenne muscular dystrophy (DMD) who are concerned about having more children?

• A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family.
• B. The male infant had a viral infection that went unnoticed and untreated, leading to muscle damage.
• C. The mother's lack of the protein dystrophin can impact the XXXX muscle groups in males.
• D. Birth trauma during a breech vaginal birth can damage the spinal cord, resulting in muscle weakness.

Correct answer: A

Rationale: The correct answer is A. Duchenne muscular dystrophy is an inherited X-linked recessive disorder that primarily affects male children in the family. Since it is X-linked, sons inherit the mutation from their mothers who are carriers of the abnormal gene. Therefore, the nurse should explain to the parents that any future sons they have would have a 50% chance of inheriting the mutation and having DMD, while daughters would have a 50% chance of being carriers like the mother.

2. When reinforcing teaching with the parents of a 7-year-old child with attention-deficit/hyperactivity disorder (ADHD) about the child's medication, which statement by the parents indicates an understanding of the medication's side effects?

• A. We should monitor our child's growth and appetite regularly.
• B. The medication may cause drowsiness, so we will give it at bedtime.
• C. We need to give the medication with food to avoid stomach upset.
• D. The medication can cause increased urination, so fluid intake should be limited.

Correct answer: A

Rationale: The correct answer is A: 'We should monitor our child's growth and appetite regularly.' Correct monitoring of the child's growth and appetite is crucial when a child is on ADHD medications, especially stimulants, as these medications can have side effects related to growth and appetite. Monitoring these parameters regularly helps in assessing the medication's impact and making any necessary adjustments. Choices B, C, and D are incorrect: B talks about drowsiness, C mentions avoiding stomach upset, and D refers to increased urination and limiting fluid intake. While these are potential side effects of medications, they do not directly address the importance of monitoring growth and appetite, which is crucial in children on ADHD medications.

3. A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (ProAir) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky, and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?

• A. When she last took the antihistamine.
• B. When her last asthma attack occurred.
• C. Duration of most asthma attacks.
• D. How often the MDI is used daily.

Correct answer: D

Rationale: The most crucial information for the nurse to obtain in this scenario is how often the metered-dose inhaler (MDI) is used daily. This information will help assess if the symptoms of insomnia, shakiness, and palpitations are potentially related to overuse of the inhaler, which can cause side effects such as tremors and palpitations. Monitoring the frequency of MDI usage is essential in managing asthma and ensuring appropriate medication administration.

4. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care?

• A. Obtain vital signs to monitor for fluid overload
• B. Change IV site dressing every 3 days and as needed
• C. Monitor for signs of facial swelling or urticaria
• D. Assess for abdominal pain and vomiting

Correct answer: C

Rationale: Monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial when administering antibiotics like azithromycin. It is important to watch for these signs to promptly identify and manage any potential adverse reactions during the course of treatment.

5. The caregiver is caring for a 2-month-old infant with a diagnosis of bronchiolitis. Which assessment finding would be most concerning to the caregiver?

• A. Nasal flaring and grunting
• B. Coughing and wheezing
• C. Poor feeding and irritability
• D. Increased respiratory rate

Correct answer: A

Rationale: Nasal flaring and grunting are indicative of respiratory distress, suggesting the infant is having difficulty breathing. This finding requires immediate attention as it signifies a more severe respiratory compromise compared to the other symptoms listed.

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