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. The caregiver is providing care to a pediatric client diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which caregiver statement regarding administration of this drug indicates correct understanding of the teaching provided by the healthcare provider?

• A. I will administer this medication between meals.
• B. I will administer this medication at bedtime.
• C. I will administer this medication one hour before meals.
• D. I will administer this medication with meals.

Correct answer: D

Rationale: The correct answer is D. Prednisone should be administered with meals to reduce gastrointestinal upset. Taking prednisone with food helps to minimize stomach irritation and other gastrointestinal side effects associated with the medication.

3. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?

• A. The child with tachypnea and pulmonary congestion
• B. The child with hepatomegaly and normal respiratory rate
• C. The child with dependent and sacral edema and regular pulse
• D. The child with periorbital edema and normal respiratory rate

Correct answer: A

Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.

4. 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.

5. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

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