Nursing Elites

1. Which interventions should the nurse include when creating a care plan for a child with hepatitis? Select one that doesn't apply.

• A. Providing a low-fat, well-balanced diet.
• B. Teaching the child effective hand-washing techniques.
• C. Notifying the primary health care provider (PHCP) if jaundice is present.
• D. Instructing the parents to avoid administering medications unless prescribed.

Correct answer: D

Rationale: The correct answer is instructing the parents to avoid administering medications unless prescribed. This choice is not directly related to the care of a child with hepatitis. It is essential for the nurse to educate the child and family about providing a low-fat, well-balanced diet to support the liver, teaching effective hand-washing techniques to prevent the spread of infection, and notifying the primary health care provider if jaundice is present to monitor the progression of the disease and adjust the treatment plan accordingly. Avoiding unnecessary medications is crucial, but it should be done under healthcare provider guidance, so the statement should be revised to reflect this aspect. Therefore, the other options are appropriate for the care of a child with hepatitis.

2. When admitting a 64-year-old patient with acute pancreatitis, the healthcare provider should specifically inquire about a history of

• A. diabetes mellitus.
• B. high-protein diet.
• C. cigarette smoking.
• D. alcohol consumption.

Correct answer: D

Rationale: In patients with acute pancreatitis, alcohol consumption is a significant risk factor and one of the most common causes in the United States. It is crucial to assess alcohol intake as it plays a key role in the development of pancreatitis. While cigarette smoking, diabetes mellitus, and high-protein diets can contribute to various health issues, they are not directly associated with the development of acute pancreatitis.

3. What is the likely cause of pericarditis in a young patient?

• A. Heart failure
• B. Acute MI
• C. Hypertension
• D. Infectious processes

Correct answer: D

Rationale: In younger patients, pericarditis is typically caused by an infection commonly triggered by viruses like the Coxsackie virus, streptococcus, staphylococcus, or Haemophilus influenzae. Infectious processes are the leading cause of pericarditis in younger individuals. Heart failure, Acute MI, and Hypertension are not common causes of pericarditis in young patients. In older adults, acute myocardial infarction (MI) is a more common cause of pericarditis.

4. Following a diagnosis of acute glomerulonephritis (AGN) in their 6-year-old child, the parent remarks, 'We just don't know how he caught the disease!' The nurse's response is based on an understanding that

• A. AGN is a streptococcal infection that involves the kidney tubules
• B. The disease is easily transmissible in schools and camps
• C. The illness is usually associated with chronic respiratory infections
• D. It is not 'caught' but is a response to a previous B-hemolytic strep infection

Correct answer: D

Rationale: Acute glomerulonephritis (AGN) is generally considered an immune-complex disease in response to a previous B-hemolytic streptococcal infection, typically occurring 4 to 6 weeks prior. It is not an infectious disease but a noninfectious renal condition. Therefore, the parent's belief that the child 'caught' the disease is inaccurate. Choice A is incorrect because AGN is not a direct streptococcal infection involving the kidney tubules but an immune response to a prior streptococcal infection. Choice B is incorrect as AGN is not easily transmissible in schools and camps. Choice C is incorrect as AGN is not usually associated with chronic respiratory infections but with a previous streptococcal infection.

5. A woman in her third trimester complains of severe heartburn. What is appropriate teaching by the nurse to help the woman alleviate these symptoms?

• A. Drink small amounts of liquids frequently
• B. Eat the evening meal at least 2-3 hours before bedtime
• C. Take sodium bicarbonate after each meal
• D. Sleep with head propped on several pillows

Correct answer: D

Rationale: During the third trimester, many women experience heartburn due to the pressure of the growing uterus on the stomach. Elevating the head while sleeping can help prevent gastric contents from refluxing back into the esophagus, thus reducing heartburn symptoms. Drinking small amounts of liquids frequently may exacerbate heartburn by increasing stomach distension. Eating the evening meal just before retiring can also worsen heartburn symptoms as lying down shortly after eating can promote reflux. Taking sodium bicarbonate after each meal is not recommended as it can disrupt the body's natural pH balance and lead to other complications.

Similar Questions