Nursing Elites

1. 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.

2. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?

• A. Recheck head control at the next visit
• B. Teach the parents appropriate exercises
• C. Schedule the child for further evaluation
• D. Refer the child for further evaluation if the anterior fontanel is still open

Correct answer: C

Rationale: Significant head lag at 8 months is concerning and warrants further evaluation, as it may indicate developmental delays or neurological issues.

3. What is the primary treatment goal for a child with juvenile idiopathic arthritis?

• A. Pain management
• B. Cure of the disease
• C. Reduction of joint deformity
• D. Physical therapy

Correct answer: A

Rationale: The primary treatment goal for a child with juvenile idiopathic arthritis is pain management. Juvenile idiopathic arthritis is a chronic condition with no known cure, making pain management crucial to improve the quality of life for these children. While reducing joint deformity and physical therapy are important aspects of managing the condition, the primary focus is on alleviating pain and improving function.

4. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

5. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?

• A. Child abuse
• B. Cultural practice to rid the body of disease
• C. Cultural practice to treat enuresis or temper tantrums
• D. Child discipline measure common in the Vietnamese culture

Correct answer: B

Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.

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