Nursing Elites

1. A child is admitted with renal failure. Which of these findings should the nurse expect?

• A. Decreased BUN
• B. Azotemia and oliguria
• C. Increased glomerular filtration rate (GFR)
• D. Polyuria and elevated creatinine clearance

Correct answer: B

Rationale: Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.

2. 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.

3. Which condition is often associated with a "ground-glass" appearance on a chest x-ray in neonates?

• A. Pneumonia
• B. Respiratory distress syndrome
• C. Bronchopulmonary dysplasia
• D. Congenital diaphragmatic hernia

Correct answer: B

Rationale: The correct answer is B, Respiratory distress syndrome. Respiratory distress syndrome often presents with a "ground-glass" appearance on a chest x-ray in neonates due to surfactant deficiency. Choice A, Pneumonia, typically appears as patchy infiltrates on chest x-ray. Choice C, Bronchopulmonary dysplasia, is characterized by hyperinflation and fibrosis, not a ground-glass appearance. Choice D, Congenital diaphragmatic hernia, usually shows mediastinal shift and bowel loops in the chest cavity on x-ray, not a ground-glass appearance.

4. A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?

• A. Check the urine to see if hematuria has increased.
• B. Obtain the child's blood pressure and notify the healthcare provider.
• C. Obtain serum electrolytes and send urinalysis to the laboratory.
• D. Reassure the child and encourage bed rest until the headache improves.

Correct answer: B

Rationale: Blurred vision and headache in a child with acute glomerulonephritis may indicate severe hypertension, which requires immediate assessment and intervention. Blood pressure should be checked, and the healthcare provider notified.

5. The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?

• A. A three-year-old girl of Mediterranean descent.
• B. A ten-year-old boy of Hispanic descent.
• C. A young girl of African descent.
• D. A baby of European descent.

Correct answer: A

Rationale: Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.

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