Nursing Elites

1. A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the healthcare provider expect?

• A. Proteinuria
• B. Peripheral edema
• C. Elevated hematocrit
• D. Absence of pedal pulses

Correct answer: C

Rationale: In a congenital cardiac malformation causing right-to-left shunting, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not typically associated with congenital cardiac malformations causing right-to-left shunting. Peripheral edema (Choice B) is more commonly seen in conditions causing left-sided heart failure. Absence of pedal pulses (Choice D) is not a typical finding in congenital cardiac malformations causing right-to-left shunting.

2. A nurse is evaluating a 3-year-old child’s developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay?

• A. Copying a square
• B. Hopping on one foot
• C. Catching a ball reliably
• D. Using a spoon effectively

Correct answer: A

Rationale: The correct answer is A: Copying a square. At 3 years old, children should be able to copy a square as part of their fine motor skill development. The inability to perform this task may indicate a developmental delay in fine motor skills. Choice B, hopping on one foot, typically develops around 4-5 years of age, so it is not a reliable indicator of a delay at 3. Choice C, catching a ball reliably, involves coordination skills that develop later in childhood, making it less relevant for a 3-year-old assessment. Choice D, using a spoon effectively, is more related to self-care and feeding skills rather than fine motor development, so it is not the best indicator of a developmental delay in this context.

3. Which of the following findings would indicate altered mental status in a small child?

• A. Recognition of the parents
• B. Fright at the EMT-B's presence
• C. Lack of attention to the EMT-B's presence
• D. Consistent eye contact with the EMT-B

Correct answer: C

Rationale: In small children, altered mental status can manifest as a lack of attention to the presence of unfamiliar individuals, such as the EMT-B. This lack of engagement may indicate confusion, disorientation, or impaired cognitive function. Choices A, B, and D are incorrect as recognizing parents, exhibiting fear, or maintaining consistent eye contact do not necessarily indicate altered mental status. Recognizing parents is a normal response, fear can be a typical reaction to unfamiliar situations, and making eye contact may be a sign of curiosity or comfort rather than a reflection of mental status.

4. A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

• A. We should give this drug after he eats something.
• B. We need to watch carefully for possible infections.
• C. The drug should not be stopped abruptly.
• D. He might experience weight gain with this drug.

Correct answer: A

Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.

5. What is a key assessment the nurse should perform for a 5-year-old child diagnosed with acute glomerulonephritis?

• A. Monitor blood glucose levels
• B. Monitor respiratory rate
• C. Monitor urine output
• D. Monitor for signs of infection

Correct answer: C

Rationale: Monitoring urine output is crucial in assessing kidney function in a child with acute glomerulonephritis. In this condition, there is inflammation in the glomeruli of the kidneys, affecting their ability to filter waste and excess fluids from the blood. Monitoring urine output helps evaluate the kidneys' ability to excrete waste and maintain fluid balance. Options A, B, and D are less relevant in the context of acute glomerulonephritis. Monitoring blood glucose levels is more pertinent in conditions like diabetes, monitoring respiratory rate is important for respiratory conditions, and monitoring for signs of infection is crucial in cases of suspected infections but is not the primary assessment focus in acute glomerulonephritis.

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