Nursing Elites

1. Congenital defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to accomplish what?

• A. Minimize separation anxiety
• B. Prevent urinary complications.
• C. Increase acceptance of hospitalization.
• D. Promote development of normal body image.

Correct answer: D

Rationale: Early repair of congenital genitourinary defects like hypospadias is important to promote a normal body image and avoid psychological issues as the child grows. It also helps prevent urinary complications and allows for normal development.

2. A child is admitted with suspected pyloric stenosis. Which of the following should be included in the plan of care?

• A. Monitor for signs of metabolic acidosis
• B. Observe for projectile vomiting
• C. Provide large, infrequent feedings to allow for rest
• D. Place the infant in a supine position after feeding

Correct answer: B

Rationale: The correct answer is B: 'Observe for projectile vomiting.' Projectile vomiting is a classic sign of pyloric stenosis, caused by obstruction at the pylorus. Choice A is incorrect as metabolic alkalosis, not acidosis, often occurs due to the loss of hydrochloric acid from persistent vomiting. Choice C is incorrect as frequent, small feedings are preferred to prevent overloading the stomach. Choice D is incorrect as placing the infant in an upright position after feeding can help reduce reflux.

3. A six-year-old child is admitted to the hospital with a diagnosis of urinary tract infection. Which of these factors contribute to urinary tract infections in young children?

• A. Excessive intake of carbonated beverages.
• B. Insufficient water intake to flush the kidneys.
• C. Voiding pattern of 5-6 times a day.
• D. Infrequent voiding which results in urinary stasis.

Correct answer: D

Rationale: Infrequent voiding can lead to urinary stasis, which increases the risk of urinary tract infections by allowing bacteria to multiply in the bladder. Encouraging regular voiding and proper hydration can help prevent UTIs. Choices A, B, and C are incorrect. Excessive intake of carbonated beverages may irritate the bladder but is not a direct cause of UTIs. Insufficient water intake can concentrate urine but does not necessarily lead to infections. A voiding pattern of 5-6 times a day is within the normal range and is not associated with increased UTI risk.

4. The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?

• A. We will wash our hands often, especially after diaper changes
• B. We know that roundworm can be transmitted from person to person
• C. We will be sure to continue the nitazoxanide (Alinia) orally for 3 days
• D. We will bring a stool sample to the clinic for examination in 2 weeks

Correct answer: B

Rationale: Roundworm (ascariasis) is typically transmitted through ingestion of contaminated soil, not directly from person to person. This statement indicates a misunderstanding requiring clarification.

5. The nurse is caring for a child with sickle cell anemia with the following order: Morphine Sulfate 2 mg IV every 24 hours. Morphine Sulfate is available in 10 mg/1mL. How many mL should the nurse administer?

• A. 0.2 mL
• B. 0.5 mL
• C. 1 mL
• D. 2 mL

Correct answer: A

Rationale: To administer 2 mg of Morphine Sulfate when the concentration is 10 mg/mL, the nurse should administer 0.2 mL (2 mg / 10 mg/mL = 0.2 mL). Choice B, 0.5 mL, is incorrect because it is the result of dividing 2 mg by 4 mg/mL instead of 10 mg/mL. Choice C, 1 mL, is incorrect as it would be the result of dividing 2 mg by 2 mg/mL. Choice D, 2 mL, is incorrect as it would be the result of dividing 2 mg by 1 mg/mL.

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