Nursing Elites

1. A toddler has minimal change nephrotic syndrome (MCNS) and 3+ pitting edema. Which intervention should the nurse include in the plan of care?

• A. Encourage an increased fluid intake for the toddler
• B. Place the child in an Airborne infection isolation room
• C. Increase the toddler's dietary sodium intake
• D. Administer corticosteroids to the toddler

Correct answer: D

Rationale: In managing minimal change nephrotic syndrome (MCNS) in children with pitting edema, corticosteroids are the mainstay of treatment. Corticosteroids help reduce inflammation and decrease proteinuria, addressing the underlying cause of MCNS. Therefore, the nurse should prioritize administering the prescribed corticosteroids to the toddler as part of the plan of care.

2. A young child admitted to the pediatric unit has fever, irritability, and vomiting with suspected bacterial meningitis. Which cerebrospinal fluid (CSF) result should the nurse anticipate based on these data?

• A. Decreased protein count
• B. Clear, straw-colored fluid
• C. Positive for red blood cells (RBCs)
• D. Decreased glucose level

Correct answer: D

Rationale: In bacterial meningitis, the glucose level in the cerebrospinal fluid (CSF) is typically decreased due to the increased utilization of glucose by the infecting bacteria. This metabolic change leads to a decrease in CSF glucose levels, making choice D the correct answer in this scenario. Choices A, B, and C are incorrect because bacterial meningitis usually results in an increased protein count, cloudy appearance of the CSF due to the presence of bacteria, and absence of red blood cells (RBCs) in the CSF unless there is a traumatic tap, respectively.

3. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

• A. I will make sure he gets his measles vaccine as soon as he gets home.
• B. He can stop taking his medication next week.
• C. I should check his urine for protein when he goes to the bathroom.
• D. He should eat a low-protein diet for the next few weeks.

Correct answer: C

Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.

4. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?

• A. Infection
• B. Urinary retention
• C. Easy bruising
• D. Hypoglycemia

Correct answer: A

Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.

5. A parent of an infant with gastroesophageal reflux is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?

• A. Offer the infant feedings every 2 hours.
• B. Position the infant upright after feedings.
• C. Feed the infant thickened formula.
• D. Place the infant in a prone position after feedings.

Correct answer: B

Rationale: Correct posture after feedings is crucial for an infant with gastroesophageal reflux to reduce the risk of regurgitation. Placing the infant upright helps prevent the backflow of stomach contents into the esophagus, minimizing symptoms of reflux.

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