Nursing Elites

1. What changes could the school nurse implement at the school to help reduce students’ risk for developing type 2 diabetes?

• A. Increase the amount of daily physical activity.
• B. Decrease the amount of daily physical activity.
• C. Test each child’s urine monthly.
• D. Teach parents to avoid administering aspirin to their child.

Correct answer: A

Rationale: Increasing physical activity helps improve insulin sensitivity and can prevent or delay the onset of type 2 diabetes in children. Regular physical activity is a key component in managing weight and reducing the risk of chronic diseases. Decreasing physical activity (Choice B) would not be beneficial in reducing the risk of type 2 diabetes. Testing each child’s urine monthly (Choice C) is not directly related to preventing type 2 diabetes. Teaching parents to avoid administering aspirin to their child (Choice D) is important for Reye's syndrome prevention but not directly related to reducing the risk of type 2 diabetes.

2. Why are neonates predisposed to problems with thermoregulation?

• A. Renal function is not fully developed.
• B. Flexed posture favors heat loss.
• C. A large body surface area favors heat loss to the environment.
• D. A thick layer of subcutaneous fat provides excellent insulation.

Correct answer: C

Rationale: Neonates have a large surface area relative to their weight, which makes them prone to heat loss to the environment, leading to thermoregulation issues. The underdeveloped kidney affecting urine concentration (Choice A) is unrelated to the thermal regulation process. While a flexed posture can help retain heat (Choice B), it does not outweigh the impact of the large body surface area in neonates. Although subcutaneous fat (Choice D) provides insulation, in neonates, the large body surface area is more significant in contributing to heat loss than the fat's insulating properties.

3. The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?

• A. Gently tap over the site.
• B. Apply a cold compress to the site.
• C. Raise the extremity above the level of the body
• D. Use a rubber band as a tourniquet for 5 minutes.

Correct answer: A

Rationale: Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.

4. Apgar scoring is conducted at 1 minute and 5 minutes after birth. It is used to determine:

• A. Major body systems’ responses at birth
• B. Future intelligence of the newborn
• C. Level of parent and newborn interaction
• D. Gestational age of the newborn

Correct answer: A

Rationale: The Apgar score assesses a newborn's physical condition immediately after birth by evaluating heart rate, respiratory effort, muscle tone, reflex response, and color. Therefore, the correct answer is A. The other choices are incorrect because B) the Apgar score does not predict future intelligence, C) it does not measure parent and newborn interaction, and D) it is not used to determine gestational age.

5. The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.)

• A. Hyponatremia
• B. Hyperkalemia
• C. All are applicable
• D. Elevated blood urea nitrogen level

Correct answer: C

Rationale: In acute renal failure, laboratory findings typically include hyperkalemia, hyponatremia, and elevated blood urea nitrogen (BUN) levels due to the kidneys' inability to excrete waste and balance electrolytes. Metabolic alkalosis is less common, with metabolic acidosis being more typical.

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