Nursing Elites

1. In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

• A. Limit fluids to reduce reflux.
• B. Give cranberry juice twice a day.
• C. Have siblings examined for VUR.
• D. Surgery is indicated to reverse scarring.

Correct answer: C

Rationale: Siblings should be examined for VUR as it can run in families, and early detection can prevent complications. Limiting fluids is not advisable, and cranberry juice is not effective in preventing VUR. Surgery is usually not indicated for scarring reversal.

2. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

• A. Focus communication on the child.
• B. Use easy analogies when possible.
• C. Explain experiences of others to the child
• D. Assure the child that communication is private

Correct answer: A

Rationale: Focusing communication directly on the child aligns with their egocentric nature and helps engage them in the conversation.

3. Which clinical manifestations should the nurse expect in a child diagnosed with nephroblastoma?

• A. Atrial fibrillation
• B. Endocarditis
• C. Hyperlipidemia
• D. Hypertension

Correct answer: D

Rationale: The correct answer is D: Hypertension. Nephroblastoma, also known as Wilms' tumor, often causes hypertension due to its impact on the kidney, which plays a role in regulating blood pressure. Atrial fibrillation (choice A) and endocarditis (choice B) are not typically associated with nephroblastoma. Hyperlipidemia (choice C) is also not a common clinical manifestation of nephroblastoma.

4. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?

• A. Child abuse
• B. Cultural practice to rid the body of disease
• C. Cultural practice to treat enuresis or temper tantrums
• D. Child discipline measure common in the Vietnamese culture

Correct answer: B

Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.

5. Which disease requires strict isolation due to its mode of transmission?

• A. Mumps
• B. Chickenpox
• C. Exanthema subitum (roseola)
• D. Erythema infectiosum (fifth disease)

Correct answer: B

Rationale: The correct answer is Chickenpox (choice B). Chickenpox is highly communicable and requires strict isolation to prevent the spread of the virus through direct contact, droplet transmission, and contaminated objects. Mumps (choice A) is also contagious but does not typically require strict isolation. Exanthema subitum (roseola) (choice C) and Erythema infectiosum (fifth disease) (choice D) are not as highly contagious as chickenpox and do not necessitate strict isolation.

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