Nursing Elites

1. A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child’s prognosis is related to what factor?

• A. Admission blood pressure
• B. Creatinine clearance
• C. Amount of protein in urine
• D. Response to steroid therapy

Correct answer: D

Rationale: The prognosis for children with MCNS is closely related to their response to steroid therapy. A favorable response to steroids usually indicates a better prognosis, while poor response may require alternative treatments and can indicate a more complicated disease course.

2. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?

• A. On the lower jaw
• B. Side of the tongue
• C. Against the soft palate
• D. Center back area of the tongue

Correct answer: B

Rationale: The side of the tongue is the appropriate place for a tongue blade to avoid triggering the gag reflex during assessment of the mouth and throat.

3. The parent of a 1-month-old infant voices concern about the infant’s respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide?

• A. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.
• B. The respirations of a 1-month-old infant are normally irregular and periodically pause.
• C. An infant at this age should have regular respirations.
• D. The irregularity of the infant's respirations is concerning; I will notify the health care provider.

Correct answer: B

Rationale: The correct answer is B. Irregular respirations with periodic pauses are normal in a 1-month-old infant. Choice A is incorrect because the normal respiratory rate for an infant at this age is higher than the range provided. Choice C is incorrect as irregular respirations are expected in infants. Choice D is not appropriate as irregular respirations with periodic pauses are a normal finding in young infants and do not necessarily indicate a concern that requires immediate notification of the healthcare provider.

4. Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? (Select all that apply.)

• A. It is ready to be used immediately.
• B. All below
• C. There is less restriction of activity with a fistula.
• D. It produces dilation and thickening of the superficial vessels.

Correct answer: A

Rationale: A fistula typically has fewer complications, allows for greater freedom of movement, and involves natural vessel changes that improve dialysis efficiency. However, it is not ready for immediate use, which is why it may take weeks to mature before it can be used.

5. Which condition is characterized by a "barking" cough in children?

• A. Asthma
• B. Bronchiolitis
• C. Croup
• D. Pneumonia

Correct answer: C

Rationale: Croup is the correct answer. It is characterized by a distinctive "barking" cough, typically worse at night, caused by the inflammation of the upper airway, specifically the larynx and trachea. Asthma (Choice A) typically presents with wheezing and shortness of breath rather than a barking cough. Bronchiolitis (Choice B) commonly causes wheezing and respiratory distress in infants and young children. Pneumonia (Choice D) often presents with symptoms like fever, productive cough, and chest pain, but not typically a barking cough.

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