Nursing Elites

1. When explaining exercise in type 1 diabetes to the parents of a newly diagnosed child, what should the nurse emphasize?

• A. Exercise will increase blood glucose levels
• B. Exercise should be restricted
• C. Extra snacks are needed before exercise
• D. Extra insulin is required during exercise

Correct answer: C

Rationale: In children with type 1 diabetes, it is essential to emphasize the need for extra snacks before exercise to prevent hypoglycemia. Choice A is incorrect because exercise typically lowers blood glucose levels, not increases them. Choice B is inappropriate as exercise is beneficial but needs to be managed carefully. Choice D is inaccurate as extra insulin during exercise can lead to hypoglycemia.

2. An 8-year-old child with the diagnosis of meningitis is to have a lumbar puncture. What should the nurse explain is the purpose of this procedure?

• A. To measure the pressure of cerebrospinal fluid
• B. To obtain a sample of cerebrospinal fluid for analysis
• C. To relieve intracranial pressure
• D. To assess the presence of infection in the spinal fluid

Correct answer: B

Rationale: The primary purpose of a lumbar puncture is to obtain a sample of cerebrospinal fluid for analysis. This sample helps in diagnosing conditions such as meningitis by evaluating the presence of pathogens or abnormalities in the cerebrospinal fluid. Measuring the pressure of cerebrospinal fluid (Choice A) is not the main objective of a lumbar puncture, although it can be done during the procedure. Relieving intracranial pressure (Choice C) is not the direct purpose of a lumbar puncture, as other interventions are typically used for this purpose. Assessing the presence of infection in the spinal fluid (Choice D) is related to the overall goal of obtaining a sample for analysis, making it a secondary outcome of the procedure.

3. When caring for a 2-year-old girl who is wheezing and has difficulty breathing, which interview question would provide the most useful information related to the symptoms of the child?

• A. Inquiring about child safety in the home
• B. Asking about the temperament of the child
• C. Asking about the child's diet
• D. Asking the parents if they smoke in the home

Correct answer: D

Rationale: Asking the parents if they smoke in the home is the most relevant question as exposure to secondhand smoke can exacerbate respiratory symptoms like wheezing and difficulty breathing in children. This information is crucial for identifying potential triggers for the child's symptoms. Inquiring about child safety in the home, asking about the child's temperament, and inquiring about the child's diet, while important aspects of care, may not directly address the respiratory symptoms the child is experiencing.

4. A 2-year-old child who was admitted to the hospital for further surgical repair of a clubfoot is standing in the crib, crying. The child refuses to be comforted and calls for the mother. As the nurse approaches the crib to provide morning care, the child screams louder. Knowing that this behavior is typical of the stage of protest, what is the most appropriate nursing intervention?

• A. Use comforting measures while holding the child.
• B. Fill the basin with water and bathe the child.
• C. Sit by the crib and bathe the child later when the anxiety decreases.
• D. Postpone the bath for a day because a child this upset should not be traumatized further.

Correct answer: C

Rationale: During the stage of protest, children may display distress when separated from their primary caregiver. Sitting by the crib and providing comfort when the child is less anxious is an appropriate intervention. Choice A is incorrect because attempting to hold the child while they are in distress may escalate the situation. Choice B is inappropriate as it ignores the child's emotional distress and proceeds with a task that can wait. Choice D is not the best option as postponing the bath for a day is not necessary; instead, addressing the child's emotional needs promptly is crucial in this situation.

5. The healthcare provider closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?

• A. infection
• B. hypertension
• C. encephalopathy
• D. edema

Correct answer: A

Rationale: Monitoring the temperature of a child with minimal change nephrotic syndrome is crucial for detecting early signs of infection, a common complication in this condition. In nephrotic syndrome, the child's immune system is compromised, making them more susceptible to infections. Monitoring for fever or any changes in temperature can help healthcare providers intervene promptly to prevent further complications. Hypertension (choice B) is not typically associated with minimal change nephrotic syndrome. Encephalopathy (choice C) refers to brain dysfunction and is not a common complication of nephrotic syndrome. Edema (choice D) is a primary manifestation of nephrotic syndrome but is not typically monitored through temperature assessment.

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