Nursing Elites

1. A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and initiate oxygen therapy. En route to the hospital, you should be most alert for

• A. vomiting
• B. seizures
• C. combativeness
• D. respiratory distress

Correct answer: B

Rationale: Seizures are a common complication in children with high fever and altered mental status, indicating a risk of febrile seizures. While vomiting can occur with altered mental status, seizures are of higher concern due to the association with febrile illnesses in children. Combativeness may be a concern in some altered mental status cases but is not as common as seizures. Respiratory distress, although important, is not the primary concern in this scenario given the symptoms presented.

2. A group of nursing students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The correct answer is 'Hormonal secretion' (Choice B). The primary function of the endocrine system is to secrete hormones that regulate various bodily functions such as metabolism, growth, and reproduction. Choice A, 'Regulation of water balance,' is primarily controlled by the kidneys and the urinary system, not the endocrine system. Choice C, 'Cellular metabolism,' is more directly related to the functions of individual cells rather than the overall function of the endocrine system. Choice D, 'Growth stimulation,' is a function that can be influenced by hormones secreted by the endocrine system, but it is not the primary function of the system.

3. A child has been diagnosed with nephrotic syndrome, and a nurse is providing care. What is the priority nursing intervention?

• A. Administering diuretics
• B. Monitoring urine output
• C. Administering corticosteroids
• D. Restricting fluid intake

Correct answer: B

Rationale: The priority nursing intervention when caring for a child with nephrotic syndrome is monitoring urine output. This is essential for assessing kidney function and managing the condition effectively. Administering diuretics (Choice A) may be a part of the treatment plan but should not be the priority over monitoring urine output. Administering corticosteroids (Choice C) may also be a treatment for nephrotic syndrome, but monitoring urine output takes precedence. Restricting fluid intake (Choice D) may be necessary in some cases, but it is not the priority intervention compared to monitoring urine output for early detection of changes in kidney function.

4. The healthcare professional is assessing a 4-year-old client. Which finding suggests to the healthcare professional this child may have a genetic disorder?

• A. Inquiry reveals the child had feeding problems.
• B. The child weighs 40 lb (18.2 kg) and is 40 in (101.6 cm) in height.
• C. The child has low-set ears with lobe creases.
• D. The child can hop on one foot but cannot skip.

Correct answer: C

Rationale: Low-set ears with lobe creases are often associated with genetic disorders and can indicate underlying chromosomal abnormalities. This physical characteristic is known to be a common sign in various syndromes like Down syndrome. Choices A, B, and D are not directly linked to genetic disorders. Feeding problems and specific weight/height measurements are more general indicators of growth and development, while the ability to hop on one foot but not skip is a developmental milestone assessment that does not specifically point towards a genetic disorder.

5. During a physical examination of a 9-month-old baby, the nurse observes a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule.
• B. Macule.
• C. Vesicle.
• D. Scale.

Correct answer: B

Rationale: The correct answer is B: Macule. A macule is a flat, discolored area on the skin that is smaller than 1 cm in diameter. This term is used to describe conditions like freckles or petechiae. Choice A, Papule, refers to a small, solid, raised skin lesion (<0.5 cm) like a pimple. Choice C, Vesicle, describes a small blister filled with clear fluid. Choice D, Scale, refers to flakes or plates of dead skin that may be dry or greasy.

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