Nursing Elites

1. When reinforcing information about the use of corticosteroids in treating asthma in children, which statement indicates that the parent understands the teaching?

• A. My child should take the medication only when experiencing symptoms.
• B. I will rinse my child's mouth after each use of the inhaler.
• C. I should discontinue the medication if my child seems better.
• D. Corticosteroids are used for quick relief during an asthma attack.

Correct answer: B

Rationale: Rinsing the mouth after using corticosteroid inhalers is crucial as it helps prevent oral thrush, a common side effect associated with these medications. This practice reduces the risk of developing fungal infections in the mouth and throat, maintaining optimal oral health during asthma treatment.

2. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?

• A. Induce vomiting using Ipecac to remove the corrosive agent.
• B. Administer vinegar or lemon juice to neutralize the caustic agent.
• C. Give activated charcoal to decontaminate the stomach.
• D. Telephone the poison control center and follow their advice.

Correct answer: D

Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.

3. A 7-year-old child is admitted to the hospital with nephrotic syndrome. The nurse notes that the child has gained 3 pounds in the past 24 hours. What should the nurse do first?

• A. Administer a diuretic as prescribed
• B. Restrict the child’s fluid intake
• C. Notify the healthcare provider
• D. Measure the child’s abdominal girth

Correct answer: C

Rationale: In a child with nephrotic syndrome experiencing sudden weight gain, the priority action for the nurse is to notify the healthcare provider. This weight gain could indicate worsening edema or fluid retention, necessitating immediate medical evaluation and intervention. The healthcare provider can conduct a comprehensive assessment, order necessary tests, and adjust the treatment plan accordingly. Administering a diuretic, restricting fluid intake, or measuring abdominal girth should not be initiated without healthcare provider consultation to ensure appropriate management of the child's condition.

4. A 15-year-old client with type 1 diabetes presents to the clinic for a routine follow-up. The nurse notes that the client’s hemoglobin A1c is 10%. What should the nurse include in the plan of care?

• A. Increase the frequency of self-monitoring of blood glucose.
• B. Discuss dietary changes to reduce carbohydrate intake.
• C. Review the client’s insulin administration technique.
• D. All of the above

Correct answer: D

Rationale: A hemoglobin A1c of 10% indicates poor blood glucose control, reflecting an average blood sugar level over the past 2-3 months. To improve control, the plan of care should be comprehensive. Increasing the frequency of self-monitoring of blood glucose helps track changes in blood sugar levels. Discussing dietary changes to reduce carbohydrate intake can aid in better blood sugar management. Reviewing the client’s insulin administration technique ensures proper medication dosing. Therefore, all the options (increasing monitoring, discussing dietary changes, and reviewing insulin administration) are essential components of the plan of care to address the client's poor blood glucose control. The correct answer is D because all these interventions are crucial for managing the client's condition effectively. Choices A, B, and C individually address different aspects of diabetes management and are all necessary in this scenario.

5. A mother reports to the nurse at the pediatric clinic that her toddler has had a fever and sore throat for the past two days. The nurse observes several swollen red spots on the child's body, some of which are fluid-filled blisters. What action should the nurse take?

• A. Obtain a fluid culture from the blisters
• B. Administer a fever-reducing medication
• C. Cover the draining vesicles with a dressing
• D. Implement transmission precautions

Correct answer: D

Rationale: The presence of swollen red spots and fluid-filled blisters may indicate a contagious condition. Implementing transmission precautions is crucial to prevent the spread of the infection to others in the clinic setting.

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