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 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her

• A. on her left side
• B. in the prone position
• C. in the supine position
• D. in a semi-sitting position

Correct answer: A

Rationale: Transporting a pregnant woman who is having a seizure on her left side is crucial as it helps improve blood flow to the fetus and reduces the risk of further complications. Placing her in the prone position or supine position may compromise blood flow to the fetus and worsen the situation. A semi-sitting position is also not recommended as it may not provide optimal blood flow to the fetus or adequately protect the airway during a seizure.

3. A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the professional determine is the last sign of heart failure?

• A. Tachypnea
• B. Tachycardia
• C. Peripheral edema
• D. Periorbital edema

Correct answer: C

Rationale: Peripheral edema is often considered the last sign of heart failure in infants and children. It indicates significant fluid retention and circulatory compromise. Tachypnea (increased respiratory rate) and tachycardia (increased heart rate) are early signs of heart failure due to inadequate cardiac output. Periorbital edema, while a sign of excess fluid, typically occurs earlier in the progression of heart failure compared to peripheral edema.

4. A child with a diagnosis of hemophilia is admitted to the hospital with a bleeding episode. What is the priority nursing intervention?

• A. Administering pain medication
• B. Monitoring for signs of infection
• C. Administering factor VIII
• D. Ensuring a safe environment

Correct answer: C

Rationale: The correct answer is administering factor VIII. Hemophilia is a genetic disorder characterized by a deficiency in clotting factors, such as factor VIII. Administering factor VIII is crucial in managing bleeding episodes in hemophiliac patients. Pain medication (Choice A) may be necessary but is not the priority in this situation. Monitoring for signs of infection (Choice B) is important for overall care but is not the priority during a bleeding episode. Ensuring a safe environment (Choice D) is also important but not the priority intervention when managing a bleeding episode in a child with hemophilia.

5. What is a key assessment the nurse should perform for a 5-year-old child diagnosed with acute glomerulonephritis?

• A. Monitor blood glucose levels
• B. Monitor respiratory rate
• C. Monitor urine output
• D. Monitor for signs of infection

Correct answer: C

Rationale: Monitoring urine output is crucial in assessing kidney function in a child with acute glomerulonephritis. In this condition, there is inflammation in the glomeruli of the kidneys, affecting their ability to filter waste and excess fluids from the blood. Monitoring urine output helps evaluate the kidneys' ability to excrete waste and maintain fluid balance. Options A, B, and D are less relevant in the context of acute glomerulonephritis. Monitoring blood glucose levels is more pertinent in conditions like diabetes, monitoring respiratory rate is important for respiratory conditions, and monitoring for signs of infection is crucial in cases of suspected infections but is not the primary assessment focus in acute glomerulonephritis.

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