Nursing Elites

1. A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse’s most appropriate response?

• A. Praise the parent for the decision and encourage the plan.
• B. Ask for more specific information related to the developmental delays.
• C. Advise the parent to have the healthcare provider help choose an appropriate program.
• D. Explain that this may be a premature action and the developmental delays could disappear.

Correct answer: B

Rationale: The most appropriate response for the nurse in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the situation, offer appropriate support, and provide guidance tailored to the child's specific needs. Praising the parent or encouraging the plan without understanding the full context may not be beneficial. Advising the parent to have the healthcare provider help choose a program assumes the parent has not already involved the healthcare provider, which may not be the case. Explaining that the developmental delays could disappear is not appropriate as it may give false hope or minimize the parent's concerns.

2. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?

• A. Mental retardation
• B. Inherited genetic factors
• C. Delayed physical growth
• D. Clubbing of the fingertips

Correct answer: C

Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.

3. The healthcare provider is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

• A. abdominal swelling
• B. weight gain
• C. hypotension
• D. increased urinary output

Correct answer: A

Rationale: Abdominal swelling is a classic presentation and often the first noticeable sign of a Wilms tumor. This occurs due to the tumor mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a presenting symptom compared to abdominal swelling. Hypotension (Choice C) is not typically associated with a Wilms tumor unless complications like bleeding or shock occur. Increased urinary output (Choice D) is not a typical finding for Wilms tumor; instead, patients may present with hematuria or urinary symptoms.

4. The nurse is assessing the 'resilience' of a 16-year-old boy. Which exemplifies an external protective factor that may help to promote resiliency in this child?

• A. His ability to take control of his own decisions
• B. His ability to accept his own limitations
• C. His caring relationship with members of his family
• D. His knowledge of when to continue or stop with goal achievement

Correct answer: C

Rationale: A caring relationship with family members is an external protective factor that promotes resilience. It provides emotional support, stability, and a sense of belonging, which are crucial elements in building resilience. Choices A, B, and D are more related to internal factors and individual traits rather than external factors like family relationships, which play a significant role in promoting resilience. Taking control of decisions, accepting limitations, and knowing when to stop or continue with goals are internal factors that contribute to personal resilience but do not directly represent external protective factors like family relationships.

5. An additional defect is associated with exstrophy of the bladder. For what anomaly should the nurse assess the infant?

• A. Imperforate anus
• B. Absence of one kidney
• C. Congenital heart disease
• D. Pubic bone malformation

Correct answer: D

Rationale: The correct answer is D: Pubic bone malformation. Exstrophy of the bladder is commonly associated with pubic bone malformation as the condition involves a defect in the pelvic region. Imperforate anus, absence of one kidney, and congenital heart disease are not typically associated with exstrophy of the bladder, making them incorrect choices. Therefore, the nurse should primarily assess the infant for pubic bone malformation in this case.

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