Nursing Elites

1. A healthcare provider is assessing a child with suspected pneumonia. What clinical manifestation is the provider likely to observe?

• A. Cough
• B. Diarrhea
• C. Rash
• D. Vomiting

Correct answer: A

Rationale: A cough is a common clinical manifestation of pneumonia. Pneumonia often presents with symptoms such as cough, fever, chest pain, and difficulty breathing. The inflammation and infection in the lungs lead to the characteristic cough observed in patients with pneumonia. Diarrhea, rash, and vomiting are not typically associated with pneumonia and are less likely to be observed in a child with this condition.

2. The parents of a child with asthma ask the nurse how they can help their child prevent asthma attacks. What should the nurse advise?

• A. Avoid exposure to allergens
• B. Encourage regular exercise
• C. Provide a high-protein diet
• D. Increase fluid intake

Correct answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are often triggered by allergens such as dust mites, pollen, pet dander, and mold. By minimizing the child's exposure to these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise is beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general well-being but do not specifically address asthma prevention.

3. A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn’t believe me.' Legally, who should the nurse notify?

• A. Police regarding a potential sex crime
• B. Health care provider to confirm the pregnancy
• C. Child Protective Services for immediate intervention
• D. The girl’s mother about the positive pregnancy test result

Correct answer: C

Rationale: In cases of child abuse and ongoing molestation, as described in the scenario, the primary concern is the safety and well-being of the child. Child Protective Services should be notified immediately for intervention to protect the girl and other children in the household from further harm. The police may be involved later to investigate the criminal aspect of the abuse. Notifying the healthcare provider solely to confirm the pregnancy or informing the girl’s mother about the positive test result does not address the urgent need for intervention and protection from abuse. Child Protective Services are trained to handle such cases and provide the necessary support and protection for the child and other vulnerable individuals in the family. Immediate action is crucial to ensure the girl's safety and prevent further harm.

4. The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.

• A. A family consists of parents and their offspring living together.
• B. A family is whatever the child and family say it is.
• C. A family is two or more people related or unrelated who are living together.
• D. A family is two or more genetically related persons living together with separate roles.

Correct answer: B

Rationale: In today's diverse society, the concept of family has evolved beyond traditional definitions. Choice B, 'A family is whatever the child and family say it is,' reflects the contemporary understanding that families can take various forms, based on self-identification and individual perspectives. Choice A is too restrictive, as modern families may not solely consist of parents and their offspring living together. Choice C is somewhat inclusive but lacks the recognition of self-identification and diversity within families. Choice D focuses on genetic relation and roles, which may not apply to all modern family structures. Therefore, choice B is the most suitable and inclusive definition of a modern family in today's society.

5. Which observation of the exposed abdomen is most indicative of pyloric stenosis?

• A. abdominal rigidity
• B. substernal retraction
• C. palpable olive-like mass
• D. marked distention of the lower abdomen

Correct answer: C

Rationale: In pyloric stenosis, a palpable olive-like mass in the abdomen is a classic finding. This mass is due to the hypertrophied pyloric muscle. Abdominal rigidity (choice A) is associated with conditions like peritonitis, substernal retraction (choice B) is typically seen in respiratory distress, and marked distention of the lower abdomen (choice D) is more characteristic of conditions like intestinal obstruction rather than pyloric stenosis.

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