Nursing Elites

1. When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents?

• A. High protein.
• B. Low sodium.
• C. Low fat.
• D. High carbohydrate.

Correct answer: B

Rationale: The correct diet that the practical nurse should reinforce with the parents of a child with nephrotic syndrome is a low-sodium diet. This diet is crucial for managing fluid retention and reducing the risk of edema, which are common concerns in children with nephrotic syndrome.

2. The caregiver is being educated by a healthcare provider about the use of a metered-dose inhaler (MDI) for their 8-year-old child with asthma. Which statement by the caregiver indicates a need for further teaching?

• A. I will shake the inhaler before each use
• B. My child should breathe in quickly after pressing the inhaler
• C. I should wait a minute between puffs
• D. We should use a spacer with the inhaler

Correct answer: B

Rationale: The caregiver should be informed that the child should breathe in slowly and deeply after pressing the inhaler. This allows for better medication delivery to the lungs and ensures optimal effectiveness of the treatment.

3. What response should the practical nurse (PN) provide when a school-age child asks to talk with a dying sister?

• A. Talk loudly to ensure the dying person hears and recognizes others' voices.
• B. Touch can provide a tactile presence if the dying person does not respond to words.
• C. Sitting close offers the dying person the sensation of others' presence.
• D. Although the dying person may not respond, they can still hear what is said.

Correct answer: D

Rationale: The correct response is D because it is believed that hearing is the last sense to go. Even if the dying person does not respond, speaking to them can still provide comfort. Choice A is incorrect because talking loudly is not necessary and can be distressing. Choice B is incorrect as it focuses on touch rather than the sense of hearing. Choice C is incorrect because sitting close may not necessarily help the dying person hear better.

4. The nurse is caring for a 10-year-old child who is scheduled for surgery to repair a fractured femur. The child’s parent expresses concern about the child being afraid of the surgery. What is the nurse’s best response?

• A. Children at this age are usually not afraid of surgery
• B. It’s normal for your child to feel scared. Let’s talk about what to expect
• C. You should talk to the surgeon about your child’s fear
• D. Don’t worry, your child will be fine

Correct answer: B

Rationale: Acknowledging the child’s fear and providing information about what to expect can help alleviate anxiety.

5. A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

• A. Place the child in a quiet environment
• B. Make a list of foods that the child likes
• C. Encourage the parents to rest when possible
• D. Apply lotion to hands and feet

Correct answer: A

Rationale: The correct intervention for a child with Kawasaki disease, presenting with irritability and skin peeling, is to place the child in a quiet environment. This helps reduce environmental stimuli, calming the child and aiding in managing the symptoms associated with the disease. Choice B is incorrect as addressing food preferences is not the priority in this situation. Choice C is incorrect as the focus should be on the child's immediate needs. Choice D is incorrect as applying lotion is not the first-line intervention for Kawasaki disease symptoms.

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