Nursing Elites

1. A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as?

• A. Cystometrogram
• B. Cystoscopy
• C. Voiding cystourethrogram
• D. Intravenous pyelogram

Correct answer: C

Rationale: The correct test for an x-ray examination of the bladder and urethra before and during micturition is a voiding cystourethrogram. This procedure allows visualization of the bladder and urethra while the patient is urinating to assess for any abnormalities in the anatomy or function of these structures.

2. A nurse provides dietary teaching to the guardian of a school-age child with cystic fibrosis. Which statement should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day.
• B. You should decrease your child's dietary fat intake to less than 10% of their caloric intake.
• C. You should restrict your child's calorie intake to 1,200 per day.
• D. You should give your child a multivitamin once weekly.

Correct answer: A

Rationale: The correct answer is A. High-protein meals and snacks are essential for children with cystic fibrosis due to their increased nutritional needs. Protein helps in maintaining muscle mass and overall health in individuals with cystic fibrosis, making it crucial to include in their diet. Choices B, C, and D are incorrect because decreasing dietary fat intake to less than 10% of caloric intake, restricting calorie intake to 1,200 per day, and giving a multivitamin once weekly are not appropriate dietary recommendations for a child with cystic fibrosis.

3. A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?

• A. Urinary tract infection
• B. Nephrotic syndrome
• C. Acute glomerulonephritis
• D. Vesicoureteral reflux

Correct answer: A

Rationale: The signs and symptoms of dysuria and urgency in a child with daytime enuresis typically indicate a urinary tract infection (UTI). These symptoms, along with urinary frequency and pain during urination, are common manifestations of a UTI in children. Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than dysuria and urgency. Acute glomerulonephritis presents with hematuria, proteinuria, hypertension, and oliguria, not dysuria and urgency. Vesicoureteral reflux can lead to recurrent UTIs but does not directly cause dysuria and urgency.

4. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?

• A. My daughter should wash and wipe the perineal area from front to back.
• B. I am only going to have my daughter wear cotton underwear.
• C. It is acceptable to take frequent bubble baths.
• D. She needs to drink lots of fluids and void frequently.

Correct answer: C

Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.

5. A child is being assessed for Kawasaki disease. Which of the following findings should be expected?

• A. Decreased heart rate
• B. Dry, scaly skin
• C. Fever unresponsive to antipyretics
• D. Nontender cervical lymphadenopathy

Correct answer: C

Rationale: In Kawasaki disease, a child typically presents with a fever that is unresponsive to antipyretics because the disease is characterized by systemic inflammation. The persistent fever is a hallmark feature of the disease and can last for more than five days despite treatment with antipyretics.

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