Nursing Elites

1. Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? (Select all that apply.)

• A. It is ready to be used immediately.
• B. All below
• C. There is less restriction of activity with a fistula.
• D. It produces dilation and thickening of the superficial vessels.

Correct answer: A

Rationale: A fistula typically has fewer complications, allows for greater freedom of movement, and involves natural vessel changes that improve dialysis efficiency. However, it is not ready for immediate use, which is why it may take weeks to mature before it can be used.

2. The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group?

• A. Peers
• B. Parents
• C. Siblings
• D. Teachers

Correct answer: A

Rationale: Adolescents typically identify and relate more closely to their peer group, especially during the teenage years when peer relationships become a central focus.

3. The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

• A. A white reflex
• B. Blue-tinged sclerae
• C. A red reflex
• D. Yellow-tinged sclerae

Correct answer: A

Rationale: The correct answer is A: A white reflex. The 'white reflex' or leukocoria is a common sign of retinoblastoma. It occurs when the light reflects off the tumor in the eye, giving the pupil a white appearance instead of the normal red reflex. Blue-tinged sclerae (choice B) and yellow-tinged sclerae (choice D) are not typical manifestations of retinoblastoma. A red reflex (choice C) is the normal reflection seen in the eye when light is shone on it and is not associated with retinoblastoma.

4. In teaching parents about appropriate pacifier selection, the nurse should recommend which characteristic?

• A. Easily grasped handle
• B. Detachable shield for cleaning
• C. Soft, pliable material
• D. Ribbon or string to secure to clothing

Correct answer: A

Rationale: A pacifier with an easily grasped handle is safer and more convenient for the infant to use without the risk of choking hazards that detachable parts might pose.

5. What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age?

• A. Give large push-pull toys for kinetic stimulation
• B. Place a cradle gym across the crib to help develop fine motor skills
• C. Provide the child with finger paints to enhance fine motor skills
• D. Provide a stick horse to develop gross motor coordination

Correct answer: A

Rationale: Large push-pull toys are suitable for a 12-month-old as they encourage gross motor skills and physical activity, which are crucial for their development at this age.

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