Nursing Elites

1. Which other congenital defects are common in children with Down syndrome?

• A. Hypospadias
• B. Pyloric stenosis
• C. Heart defects
• D. Hip dysplasia

Correct answer: C

Rationale: The correct answer is C: Heart defects. Many children with Down syndrome are born with congenital heart defects. These heart abnormalities are more prevalent in individuals with Down syndrome than in the general population. Choices A, B, and D are incorrect because while they may be congenital defects in children, they are not commonly associated with Down syndrome. Hypospadias is a urogenital condition, pyloric stenosis affects the stomach, and hip dysplasia involves the hip joint, but these are not typically seen as frequently as heart defects in children with Down syndrome.

2. A client with Addison's disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

• A. Osmolarity
• B. Glucose
• C. Albumin
• D. Platelets

Correct answer: B

Rationale: The correct answer is B: Glucose. Hydrocortisone can lead to increased blood glucose levels, so monitoring glucose is crucial to assess for hyperglycemia, a common side effect of corticosteroid therapy. Monitoring osmolarity (choice A) is not typically indicated in this scenario. Albumin (choice C) and platelets (choice D) are not directly affected by hydrocortisone therapy and are not the primary focus of monitoring in this case.

3. Before selecting which medication to administer, which action should the nurse implement if a postoperative client reports incisional pain and has two prescriptions for PRN analgesia?

• A. Compare the client’s pain scale rating with the prescribed dosing.
• B. Determine which prescription will have the quickest onset of action.
• C. Ask the client to choose which medication is needed for the pain.
• D. Document the client’s report of pain in the electronic medical record.

Correct answer: A

Rationale: When a postoperative client reports incisional pain and has two prescriptions for PRN analgesia, the nurse should first compare the client’s pain scale rating with the prescribed dosing. This action ensures that the client receives the appropriate medication based on their pain level. Determining the onset of action or asking the client to choose the medication does not guarantee that the right medication is administered according to the pain intensity. Documenting the pain report is important but should not be the first action when deciding which medication to administer.

4. When interacting with the parents of a SIDS infant, the nurse should attempt to assist the parents with:

• A. Encouraging the parents to have another baby.
• B. Encouraging the parents to remain stoic.
• C. Allaying feelings of guilt and blame.
• D. Learning how the event could have been prevented.

Correct answer: C

Rationale: The correct answer is C: Allaying feelings of guilt and blame. When parents experience the loss of a SIDS infant, they often struggle with intense feelings of guilt and self-blame. The nurse's role is to provide emotional support and help alleviate these feelings. Choices A and B are incorrect as encouraging the parents to have another baby or to remain stoic is not appropriate or helpful in this situation. Choice D is also incorrect because focusing on how the event could have been prevented may exacerbate feelings of guilt and is not the immediate priority in supporting grieving parents.

5. What are early signs of varicella disease?

• A. High fever over 101°F (38.3°C)
• B. General malaise
• C. Increased appetite
• D. Crusty sores

Correct answer: B

Rationale: The correct early sign of varicella disease is general malaise. During the prodromal period, patients may experience low-grade fever, malaise, and anorexia. Increased appetite and crusty sores are not typically early signs of varicella. The appearance of lesions occurs later in the course of the disease.

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