Nursing Elites

1. 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.

2. A parent of an infant with diaper dermatitis is being taught by a nurse. Which of the following instructions should the nurse include?

• A. Use baby wipes that contain alcohol to clean the baby's skin.
• B. Expose the baby's skin to air.
• C. Use a blow dryer on the warm setting to dry the baby's skin.
• D. Give the baby a bath once a week.

Correct answer: B

Rationale: The nurse should instruct the parent to expose the infant's skin to air as it helps in promoting the healing process of diaper dermatitis by allowing the skin to breathe and reducing moisture, which can worsen the condition.

3. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?

• A. Infection
• B. Urinary retention
• C. Easy bruising
• D. Hypoglycemia

Correct answer: A

Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.

4. Which question provides information regarding a child's community mobility?

• A. What is the level of supervision provided?
• B. Can the child leave the house and play with friends?
• C. Is the child being bullied?
• D. Is there equipment available so the child can play with peers?

Correct answer: B

Rationale: Choice B directly assesses the child's community mobility by inquiring about their ability to leave the house and engage in play activities with friends. Community mobility involves the child's independence in social and recreational activities outside the home, making this question crucial for understanding their daily functioning and autonomy.

5. What is the probable cause recognized by the nurse when a 5-year-old boy is admitted to the hospital with acute glomerulonephritis?

• A. Recovery from German measles 2 months ago
• B. Dysuria since the previous night
• C. A history of allergy
• D. A sore throat 2 weeks ago

Correct answer: D

Rationale: Acute glomerulonephritis typically develops 1 to 3 weeks after a streptococcal infection, such as a sore throat, which triggers an allergic-type response that affects the glomeruli's function. This immune response leads to inflammation and damage to the glomeruli, resulting in acute glomerulonephritis.

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