Nursing Elites

1. When assessing a child with suspected nephrotic syndrome, what clinical manifestation is the nurse likely to observe?

• A. Jaundice
• B. Edema
• C. Hypertension
• D. Polyuria

Correct answer: B

Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased glomerular permeability leading to the loss of proteins, particularly albumin, in the urine. This results in decreased oncotic pressure, leading to fluid shifting into the interstitial spaces and causing edema. Jaundice (Choice A) is not a typical clinical manifestation of nephrotic syndrome. Hypertension (Choice C) is more commonly associated with conditions like glomerulonephritis. Polyuria (Choice D) is not a primary symptom of nephrotic syndrome; instead, patients may have reduced urine output due to fluid retention from edema.

2. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, increasing the risk of infections. Detecting and managing infections promptly is crucial to prevent complications and improve outcomes. Providing nutritional support is important, but infection prevention takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of bleeding is relevant in leukemia due to decreased platelet count, but infection surveillance is more critical. Monitoring for signs of pain is essential, but addressing infections promptly is the priority to prevent further deterioration in the child's condition.

3. The nurse is teaching a group of parents about the side effects of immunization vaccines. Which sign should the nurse include when discussing an infant receiving the Haemophilus influenzae (Hib) vaccine?

• A. Lethargy
• B. Urticaria
• C. Generalized rash
• D. Low-grade fever

Correct answer: D

Rationale: The correct answer is 'D. Low-grade fever.' A low-grade fever is a common and mild side effect of the Hib vaccine, indicating that the immune system is responding to the immunization. Lethargy (choice A) can be a sign of more serious adverse effects and should be monitored closely but is not typically associated with the Hib vaccine. Urticaria (choice B) and generalized rash (choice C) are less common side effects of the Hib vaccine compared to low-grade fever.

4. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Eating meals at home is recommended.
• B. Food portions should be measured using a gram scale.
• C. Ensure a ready source of glucose is available.
• D. No specific foods need to be cooked for the adolescent.

Correct answer: C

Rationale: When teaching an adolescent with type 1 diabetes about dietary management, it is crucial to ensure a ready source of glucose is available. In cases of hypoglycemia, having a quick source of glucose can help raise blood sugar levels rapidly. Option A is not the most critical aspect of dietary management for an adolescent with type 1 diabetes. While it is generally recommended to eat meals at home for better control over food choices, the availability of a ready glucose source takes precedence. Option B, weighing foods on a gram scale, may not be practical for every meal and could be burdensome. Option D, cooking specific foods for the adolescent, is not necessary as the focus should be on the overall dietary plan rather than individualized meals.

5. 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 crucial to avoid foods high in salt to manage symptoms and prevent complications. Excessive salt intake can lead to fluid retention and exacerbate edema, which are common issues in nephrotic syndrome. Encouraging a high-protein diet (Choice A) may put additional strain on the kidneys and worsen the condition. While protein restriction is sometimes needed, it is not the primary dietary concern in nephrotic syndrome. Similarly, a low-protein diet (Choice D) is not typically recommended as it may lead to malnutrition in children. Although a low-sodium diet (Choice C) may sound similar to avoiding foods high in salt, the emphasis should be on reducing salt intake specifically, rather than a generalized low-sodium approach.

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