Nursing Elites

1. A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?

• A. Palpate the child's abdomen daily for tumor size.
• B. Reposition the child frequently.
• C. Prepare the child for chemotherapy.
• D. Avoid palpating the abdomen.

Correct answer: D

Rationale: Palpating the abdomen of a child with Wilms' tumor should be avoided to prevent the risk of rupturing the tumor and spreading cancer cells. This action is crucial to maintain the child's safety and prevent potential complications before surgery.

2. Which is the priority nursing assessment when providing care for an infant at risk for dehydration?

• A. Urine output
• B. Urine specific gravity
• C. Vital signs
• D. Daily weight

Correct answer: D

Rationale: The correct answer is Daily weight. Daily weight is a crucial assessment in infants at risk for dehydration because changes in weight can indicate fluid balance and dehydration status. It is essential to monitor daily weight to promptly identify and manage dehydration in infants.

3. 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.

4. Which statement is not part of the developmental care approach?

• A. Family-centered care
• B. Care on a sliding payment scale
• C. Healing environment
• D. Protected sleep

Correct answer: B

Rationale: The developmental care approach emphasizes creating an environment that supports the infant's developmental needs, including family-centered care, a healing environment, and promoting protected sleep. Payment scale considerations are not a component of developmental care.

5. When planning care for a newborn with esophageal atresia and tracheoesophageal fistula, which is the priority nursing diagnosis?

• A. Ineffective Tissue Perfusion
• B. Ineffective Infant Feeding Pattern
• C. Acute Pain
• D. Risk for Aspiration

Correct answer: D

Rationale: The priority nursing diagnosis for a newborn with esophageal atresia and tracheoesophageal fistula is 'Risk for Aspiration' because of the potential respiratory complications associated with these conditions. The newborn is at a higher risk of aspirating oral or gastric contents due to the abnormal connections between the esophagus and trachea, posing a serious threat to the airway and lungs. Addressing this risk is crucial to prevent respiratory distress and maintain the airway's patency, making it the priority nursing diagnosis in this scenario. 'Ineffective Tissue Perfusion' is not the priority as respiratory compromise takes precedence over perfusion concerns. 'Ineffective Infant Feeding Pattern' may be relevant but addressing the risk of aspiration is more critical. 'Acute Pain' is not the priority compared to the life-threatening risk of aspiration.

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