Nursing Elites

1. 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.

2. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?

• A. “Attempt to distract the child by offering a toy to the child.”
• B. “Say nothing and allow the tantrum to continue until it ends.”
• C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
• D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”

Correct answer: B

Rationale: The nurse's best response is to allow the tantrum to continue until it ends without giving in to the child's demands. By not rewarding the child with the desired item during a tantrum, the child learns that this behavior is not effective in getting what they want. Offering a toy to distract the child (Choice A) may reinforce the idea that tantrums lead to rewards. Leaving the child with a babysitter (Choice C) does not address the issue at hand, which is teaching the child appropriate behavior in public places. Giving the child the item temporarily (Choice D) may encourage the child to have tantrums in the future to obtain desired items.

3. What intervention best meets a major developmental need of a newborn in the immediate postoperative period?

• A. Giving a pacifier to the newborn
• B. Putting a mobile over the newborn’s crib
• C. Providing the newborn with a soft, cuddly toy
• D. Warming the newborn’s formula before feeding

Correct answer: A

Rationale: The correct answer is giving a pacifier to the newborn. Sucking is a natural reflex and a source of comfort for newborns, especially postoperatively. A pacifier can help meet their developmental needs by providing soothing comfort. Choices B, C, and D do not directly address the major developmental need related to the newborn's comfort and reflexes postoperatively. Putting a mobile over the crib, providing a cuddly toy, or warming formula, although potentially beneficial in other contexts, do not specifically target the developmental need of sucking for comfort. Offering a pacifier is a safe and effective way to address this developmental need in newborns.

4. A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid?

• A. Semi-Fowler
• B. Supine
• C. High Fowler
• D. Side-lying

Correct answer: D

Rationale: The correct answer is D: Side-lying. After surgery using steel bar placement to correct pectus excavatum, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar. Choices A, B, and C are incorrect. Semi-Fowler, Supine, and High Fowler positions are generally safe and commonly used in postoperative care, but in this specific case, side-lying should be avoided to ensure the effectiveness of the surgical correction.

5. When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?

• A. They may occur in minor illnesses.
• B. The cause is usually readily identified.
• C. They usually do not occur during the toddler years.
• D. The frequency of occurrence is greater in females than males.

Correct answer: A

Rationale: The correct answer is A: 'They may occur in minor illnesses.' Febrile seizures can occur even in minor illnesses, particularly in young children, and are often triggered by a rapid increase in body temperature. Choice B is incorrect because the cause of febrile seizures is not always readily identified. Choice C is incorrect as febrile seizures commonly occur in children aged 6 months to 5 years, which includes the toddler years. Choice D is incorrect as febrile seizures are slightly more common in males than females.

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