Nursing Elites

1. A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?

• A. Urinary tract infection
• B. Nephrotic syndrome
• C. Acute glomerulonephritis
• D. Vesicoureteral reflux

Correct answer: A

Rationale: The signs and symptoms of dysuria and urgency in a child with daytime enuresis typically indicate a urinary tract infection (UTI). These symptoms, along with urinary frequency and pain during urination, are common manifestations of a UTI in children. Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than dysuria and urgency. Acute glomerulonephritis presents with hematuria, proteinuria, hypertension, and oliguria, not dysuria and urgency. Vesicoureteral reflux can lead to recurrent UTIs but does not directly cause dysuria and urgency.

2. A healthcare professional is performing hearing screenings for children at a community health fair. Which of the following children should the professional refer to a provider for a more extensive hearing evaluation?

• A. A toddler who is 18 months old and has unintelligible speech
• B. An infant who is 3 months old and has an exaggerated startle response
• C. A preschooler who is 4 years old and prefers playing with others rather than alone
• D. An infant who is 8 months old and is not yet making babbling sounds

Correct answer: D

Rationale: The healthcare professional should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a more extensive evaluation of hearing. Babbling sounds are a developmental milestone that typically occurs by 7 months of age. Delayed or absent babbling can indicate potential hearing issues that warrant further assessment.

3. A parent of a child with oral candidiasis is being taught by a nurse. Which statement by the parent indicates an understanding of the teaching?

• A. I will boil the nipples and pacifiers for 20 minutes each day.
• B. I will stop the medication as soon as the spots disappear.
• C. I will apply an over-the-counter steroid cream to the spots.
• D. I will mix the medication in my child's bottle.

Correct answer: A

Rationale: Boiling the nipples and pacifiers for 20 minutes each day is an appropriate measure to prevent reinfection of oral candidiasis. This practice helps eliminate the Candida fungus from these items, reducing the risk of the child getting reinfected. It is crucial for the parent to follow this hygienic practice consistently to ensure the child's recovery and prevent the spread of the infection.

4. A nurse is planning care for a 2-month-old infant who is postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take?

• A. Position the infant on his abdomen
• B. Cleanse the incision site with hydrogen peroxide
• C. Offer the infant a pacifier
• D. Keep the infant's elbow restrained

Correct answer: D

Rationale: The nurse should keep the infant’s elbow restrained to prevent injury to the surgical site.

5. A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer?

• A. Promethazine
• B. Epinephrine
• C. Diphenhydramine
• D. Hydroxyzine

Correct answer: B

Rationale: The patient is exhibiting symptoms of anaphylaxis triggered by a peanut allergy, a severe and potentially life-threatening allergic reaction. The appropriate medication for anaphylaxis is epinephrine. Epinephrine acts quickly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and reducing laryngeal edema, making it the drug of choice for this situation. Promethazine, diphenhydramine, and hydroxyzine are not the first-line treatments for anaphylaxis. Promethazine is an antihistamine with sedative effects, Diphenhydramine is an antihistamine, and Hydroxyzine is also an antihistamine with sedative properties. While these medications can help with mild allergic reactions, they are not as effective or fast-acting as epinephrine in treating the severe manifestations of anaphylaxis.

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