Nursing Elites

1. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.

2. The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the nurse include as a major congenital anomaly?

• A. Overlapping digits
• B. Polydactyly
• C. Umbilical hernia
• D. Cleft palate

Correct answer: D

Rationale: Cleft palate is considered a major congenital anomaly because it involves a gap or split in the roof of the mouth, which can significantly impact feeding, speech development, dental health, and overall well-being. Overlapping digits (Choice A) and polydactyly (Choice B) are examples of limb abnormalities rather than major congenital anomalies affecting vital functions. Umbilical hernia (Choice C) is a common condition where abdominal organs protrude through the belly button and is typically not considered a major congenital anomaly in the same way as cleft palate.

3. A nurse is assessing the oral cavity of a 6-month-old infant. The parent asks which teeth will erupt first. How should the nurse respond?

• A. Incisors
• B. Canines
• C. Upper molars
• D. Lower molars

Correct answer: A

Rationale: The correct answer is A: Incisors. In infants, incisors are usually the first teeth to erupt, typically around 6 months of age. These are the front teeth used for cutting food. Canines (Choice B), upper molars (Choice C), and lower molars (Choice D) typically erupt after the incisors. Canines are sharp teeth used for tearing food, while molars are flat teeth used for grinding food.

4. A child with a diagnosis of diabetes insipidus is admitted to the hospital. What is the priority nursing intervention?

• A. Administering insulin
• B. Monitoring fluid balance
• C. Administering diuretics
• D. Monitoring vital signs

Correct answer: B

Rationale: The correct answer is monitoring fluid balance. In a child with diabetes insipidus, the primary concern is excessive urination and fluid loss, which can lead to dehydration. Monitoring fluid balance is crucial to prevent dehydration and maintain electrolyte balance. Administering insulin (Choice A) is not indicated in diabetes insipidus, as this condition is not related to insulin deficiency. Administering diuretics (Choice C) should be avoided as it can exacerbate fluid loss in a child already at risk for dehydration. While monitoring vital signs (Choice D) is important, the priority intervention in this situation is monitoring fluid balance to prevent complications associated with dehydration.

5. An additional defect is associated with exstrophy of the bladder. For what anomaly should the nurse assess the infant?

• A. Imperforate anus
• B. Absence of one kidney
• C. Congenital heart disease
• D. Pubic bone malformation

Correct answer: D

Rationale: The correct answer is D, pubic bone malformation. Exstrophy of the bladder is commonly associated with pubic bone malformation because the condition involves a defect in the pelvic region. Choices A, B, and C are incorrect. Imperforate anus, absence of one kidney, and congenital heart disease are not typically associated with exstrophy of the bladder.

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