Nursing Elites

1. A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?

• A. We will keep our child away from anyone who is ill.
• B. We will be sure to administer the prednisone as ordered.
• C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
• D. We understand our child will not be able to attend school, so we will arrange for homeschooling.

Correct answer: D

Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.

2. What statement is descriptive of renal transplantation in children?

• A. It is an acceptable means of treatment after age 10 years.
• B. Children can receive kidneys only from other children.
• C. It is the preferred means of renal replacement therapy in children.
• D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Correct answer: C

Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.

3. Examination of the abdomen is performed correctly by the nurse in which order?

• A. Inspection, palpation, percussion, and auscultation
• B. Inspection, percussion, auscultation, and palpation
• C. Palpation, percussion, auscultation, and inspection
• D. Inspection, auscultation, percussion, and palpation

Correct answer: D

Rationale: The correct order for abdominal examination is inspection, auscult

4. What is the recommended position for a child after a tonsillectomy?

• A. Supine
• B. Prone
• C. Side-lying
• D. Fowler's position

Correct answer: C

Rationale: The correct answer is C: Side-lying. The side-lying position is recommended after a tonsillectomy to facilitate drainage of secretions and reduce the risk of aspiration. This position helps prevent blood from pooling in the back of the throat, decreasing the chance of bleeding postoperatively. Supine (lying face up), while commonly used in other situations, may not be ideal immediately after a tonsillectomy due to the risk of airway obstruction from blood clots. Prone (lying face down) is not recommended as it can hinder breathing and increase the risk of complications. Fowler's position (semi-sitting) is also not typically used after a tonsillectomy because it may cause discomfort and hinder proper drainage.

5. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

• A. Limit explanation of procedures because the child is preschool-aged
• B. Ask that all family members leave the room when performing procedures
• C. Allow the child to choose the type of juice to drink with the administration of oral medications
• D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective

Correct answer: C

Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.

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