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. When educating a patient about sildenafil (Viagra), which adverse effect should be a priority for the patient to report to his prescriber?

• A. Flushing
• B. Diarrhea
• C. Hearing loss
• D. Dyspepsia

Correct answer: C

Rationale: The correct answer is 'C: Hearing loss.' In rare cases, Viagra has been associated with sudden hearing loss, typically in one ear, which can be partial or complete. Any onset of hearing problems while using Viagra should be reported promptly to the prescriber. It is recommended to discontinue the medication if it is used for erectile dysfunction. 'Flushing,' 'Diarrhea,' and 'Dyspepsia' are known adverse effects of Viagra but are generally less serious compared to hearing loss.

3. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

4. While caring for four different pediatric clients, which child is at the highest risk for dehydration?

• A. 7-year-old child with migraine headaches
• B. 4-year-old child with a broken arm
• C. 2-year-old child with cellulitis of the left leg
• D. 18-month-old child with tachypnea

Correct answer: D

Rationale: The 18-month-old child with tachypnea is at the highest risk for dehydration due to increased insensible water loss associated with rapid breathing.

5. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?

• A. Bag-valve-mask system
• B. Sterile gauze and saline
• C. Soft arm restraints
• D. Endotracheal tube

Correct answer: D

Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.

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