Nursing Elites

1. A 7-year-old has been diagnosed with cystic fibrosis. Chest physiotherapy has been ordered. What information should the nurse give to the parents regarding when chest physiotherapy is done?

• A. Before aerosol treatment
• B. After suctioning
• C. Before postural drainage
• D. Before meals

Correct answer: D

Rationale: The correct answer is D: 'Before meals'. Chest physiotherapy should be performed before meals to reduce the risk of vomiting and to ensure that the airways are clear for effective nutrition. Choices A, B, and C are incorrect because chest physiotherapy is ideally done before meals to optimize its benefits and avoid complications associated with timing.

2. A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

• A. Bacteriuria and hematuria
• B. Hematuria and proteinuria
• C. Bacteriuria and increased specific gravity
• D. Proteinuria and decreased specific gravity

Correct answer: B

Rationale: Hematuria (blood in the urine) and proteinuria (protein in the urine) are common findings in acute glomerulonephritis due to inflammation of the glomeruli. Bacteriuria and changes in specific gravity are not as directly associated with this condition.

3. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

• A. Female, multiple siblings, stable home life
• B. Male, high activity level, stressful home life
• C. Male, even-tempered, history of previous injuries
• D. Female, reacts negatively to new situations, no serious previous injuries

Correct answer: B

Rationale: A male child with a high activity level and a stressful home life has multiple risk factors for childhood injuries, requiring closer supervision and preventive measures.

4. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

• A. Initiating breast or bottle-feedings to stabilize the blood glucose level
• B. Maintaining pain management with an intravenous opioid
• C. Covering the intact bowel with a nonadherent dressing to prevent injury
• D. Performing immediate surgery

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

5. The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

• A. All are correct
• B. Anorexia
• C. Hypertension
• D. Purpura

Correct answer: A

Rationale: Hemolytic uremic syndrome (HUS) typically presents with hematuria, anorexia, hypertension, and purpura due to the hemolytic anemia, thrombocytopenia, and renal failure that characterize this condition.

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