Nursing Elites

1. A child is admitted to the hospital with acute renal failure. The parents ask about the prognosis for acute renal failure. The nurse’s response should be based on which statement about acute renal failure?

• A. Children with acute renal failure will have to take prophylactic antibiotics for life.
• B. Acute renal failure always leads to chronic renal failure.
• C. Acute renal failure may be reversible.
• D. All children with acute renal failure will eventually need a kidney transplant.

Correct answer: C

Rationale: The correct answer is C: Acute renal failure in children is often reversible, especially when the underlying cause is identified and treated promptly. It does not always lead to chronic renal failure or the need for a kidney transplant. Choice A is incorrect as prophylactic antibiotics for life are not a standard treatment for acute renal failure. Choice B is incorrect as acute renal failure does not always progress to chronic renal failure. Choice D is incorrect as not all children with acute renal failure will eventually require a kidney transplant.

2. At what age is it safe to give infants whole milk instead of commercial infant formula?

• A. 6 months
• B. 9 months
• C. 12 months
• D. 18 months

Correct answer: C

Rationale: Whole milk should not be introduced before 12 months because it lacks the necessary nutrients, such as iron, that infants need for proper growth and development.

3. The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?

• A. 2 to 3 years
• B. 4 to 5 years
• C. 6 to 7 years
• D. 8 to 9 years

Correct answer: B

Rationale: The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.

4. In the newborn, into what muscle is intramuscular vitamin K administered?

• A. Deltoid
• B. Dorsogluteal
• C. Rectus femoris
• D. Vastus lateralis

Correct answer: D

Rationale: In newborns, intramuscular vitamin K is traditionally administered into the vastus lateralis muscle. This site is preferred due to its large muscle mass and accessibility. The dorsogluteal site is not recommended for newborns due to the risk of injury to the sciatic nerve. The deltoid site is also not recommended for newborns. The rectus femoris muscle is not commonly used for intramuscular injections in newborns.

5. The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?

• A. Gently tap over the site.
• B. Apply a cold compress to the site.
• C. Raise the extremity above the level of the body
• D. Use a rubber band as a tourniquet for 5 minutes.

Correct answer: A

Rationale: Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.

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