Nursing Elites

1. A child is refusing to use the potty and having accidents, even though he has achieved toilet training. This is an example of which type of behavior?

• A. Positive reinforcement
• B. Desensitization
• C. Phobia
• D. Regression

Correct answer: D

Rationale: The correct answer is D, regression. Regression occurs when a child reverts to an earlier behavior, such as having accidents after being successfully toilet trained. This regression often happens due to stress or changes in routine. Choices A, B, and C are incorrect because positive reinforcement involves encouraging desired behavior, desensitization is a process of reducing sensitivity to a stimulus, and phobia is an intense fear or aversion to a specific object or situation, none of which directly apply to the described situation of the child having accidents after being toilet trained.

2. When a pre-school child says the sun shines to keep her warm, this is an example of:

• A. Animism
• B. Artificialism
• C. Egocentrism
• D. Centering

Correct answer: B

Rationale: The correct answer is B: Artificialism. Artificialism is the belief that natural phenomena are created by human beings for human purposes. In this scenario, the child attributes human-like intentions to the sun, assuming it shines specifically to keep her warm. Choice A, Animism, is the belief that natural objects and phenomena are alive and have feelings. Choice C, Egocentrism, refers to a child's difficulty in seeing things from another person's perspective. Choice D, Centering, involves focusing on only one aspect of a situation while ignoring other relevant aspects.

3. The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

• A. Poor appetite
• B. Reduction of edema
• C. Restriction to bed rest
• D. Increased potassium intake

Correct answer: B

Rationale: The weight loss is most likely due to the reduction of edema, as glomerulonephritis often causes fluid retention that resolves with treatment, leading to significant weight loss.

4. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

• A. The antibiotic therapy contributes to labile blood pressure values.
• B. Hypotension leading to sudden shock can develop at any time.
• C. Acute hypertension is a concern that requires monitoring.
• D. Blood pressure fluctuations indicate that the condition has become chronic.

Correct answer: C

Rationale: Acute hypertension is a common complication of acute glomerulonephritis, requiring frequent monitoring to prevent complications such as encephalopathy or heart failure. Blood pressure fluctuations can occur but are not necessarily indicative of chronic disease.

5. An infant is suspected of having esophageal atresia/tracheoesophageal fistula. While waiting for the pediatrician to see the infant, which action should the nurse take?

• A. Position the infant with the head of the bed slightly elevated
• B. Allow the infant to bond with the mother in her room
• C. Offer the infant breastfeeding instead of formula feeding
• D. Wrap the infant in blankets and place in a crib by the viewing window

Correct answer: A

Rationale: Positioning the infant with the head of the bed elevated helps to prevent aspiration and manage secretions until further treatment can be provided. Choice B is incorrect as the priority is ensuring the infant's safety and health, not immediate bonding. Choice C is incorrect as breastfeeding may worsen the condition. Choice D is incorrect as it does not address the potential risk of aspiration associated with esophageal atresia/tracheoesophageal fistula.

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