Nursing Elites

1. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?

• A. Impaired Gas Exchange
• B. Risk for Infection
• C. Anxiety (parental)
• D. Acute Pain

Correct answer: A

Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.

2. A healthcare professional is preparing to collect a sample from a toddler for a sickle turbidity test. Which of the following actions should the healthcare professional plan to take?

• A. Obtain a sputum specimen
• B. Perform an Allen test
• C. Perform a finger stick
• D. Obtain a stool specimen

Correct answer: C

Rationale: The healthcare professional should perform a finger stick on a toddler as a component of the sickle turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease. Finger stick is a common method used to collect blood samples, especially in pediatric patients, for various tests.

3. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?

• A. My daughter should wash and wipe the perineal area from front to back.
• B. I am only going to have my daughter wear cotton underwear.
• C. It is acceptable to take frequent bubble baths.
• D. She needs to drink lots of fluids and void frequently.

Correct answer: C

Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.

4. The healthcare provider is providing teaching about Social Development to the parents of a preschooler. Which of the following play activities should the provider recommend for the child?

• A. Playing pat-a-cake
• B. Using a push-pull toy
• C. Creating a scrapbook
• D. Playing dress-up

Correct answer: D

Rationale: During the preschool age, play activities should promote social, mental, and physical development. Playing dress-up encourages imagination, creativity, and social interaction, making it an ideal play activity for preschoolers.

5. The nurse is reviewing the prescriber�s orders and notes that omeprazole has been order for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient�s record.

• A. Aspirin 81mg daily
• B. Clopidogrel (Plavix) 75mg daily
• C. Heparin 5000 units subQ q12hrs
• D. Metoprolol 50mg q8hrs

Correct answer: B

Rationale: For patients who lack risk factors for GI bleeding, combined use of clopidogrel with a PPI, may reduce the effects of clopidogrel without offering any real benefits and thus should be avoided.

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