Nursing Elites

1. A child has a brain tumor. Which of the following findings should the nurse expect?

• A. Decreased head circumference
• B. Frequent headaches
• C. Increased appetite
• D. Increased blood pressure

Correct answer: B

Rationale: Children with brain tumors commonly experience frequent headaches due to increased intracranial pressure. This pressure can result in pain and discomfort, leading to headaches as a common symptom. Other symptoms may include nausea, vomiting, changes in vision, and behavioral changes, but headaches are a prominent feature in children with brain tumors.

2. Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

• A. Massive proteinuria, hypoalbuminemia, and edema
• B. Hematuria, bacteriuria, and weight gain
• C. Decreased urine specific gravity and increased urinary output
• D. Gross hematuria, albuminuria, and fever

Correct answer: A

Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.

3. A child is being assessed for acute poststreptococcal glomerulonephritis (APSGN). Which of the following findings should the nurse expect?

• A. Hematuria
• B. Polyuria
• C. Hypertension
• D. Diarrhea

Correct answer: C

Rationale: In acute poststreptococcal glomerulonephritis (APSGN), hypertension is a common finding due to fluid retention and decreased kidney function. This condition often presents with hypertension as a result of sodium and water retention, as well as reduced glomerular filtration rate. Hematuria, not diarrhea, is also a common symptom of APSGN due to inflammation and damage to the glomeruli. Polyuria, an increase in urine output, is not a typical finding in APSGN unless severe kidney damage leads to decreased urine concentrating ability.

4. Which food should be avoided by a child with acute glomerulonephritis to prevent hyperkalemia, as recommended by the nurse?

• A. Dairy products
• B. Whole-grain cereals
• C. Organ meats
• D. Bananas

Correct answer: D

Rationale: Bananas are rich in potassium, which can contribute to hyperkalemia in individuals with acute glomerulonephritis. It is essential to limit potassium intake to prevent further complications associated with high potassium levels in the blood.

5. How do models of practice help therapists engage in sound therapeutic reasoning?

• A. They provide structure to guide thinking
• B. They address theory but not practice
• C. They predict the outcome of intervention
• D. They examine physical characteristics of the child

Correct answer: A

Rationale: Models of practice help therapists engage in sound therapeutic reasoning by providing a structured framework to guide their thinking process. These models offer a systematic approach that assists therapists in organizing their thoughts and decision-making processes during therapy sessions. By following a specific model, therapists can ensure they consider all relevant factors and make informed therapeutic choices, leading to effective interventions and better outcomes for their clients.

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