Nursing Elites

1. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. What is the best explanation for this considering cultural differences?

• A. The parent feels inferior to the nurse
• B. The parent is showing respect for the nurse
• C. The parent is embarrassed to seek health care
• D. The parent feels responsible for her child's illness

Correct answer: B

Rationale: In many Asian cultures, avoiding eye contact is a sign of respect, especially towards authority figures such as healthcare providers.

2. A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?

• A. We will keep our child away from anyone who is ill.
• B. We will be sure to administer the prednisone as ordered.
• C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
• D. We understand our child will not be able to attend school, so we will arrange for homeschooling.

Correct answer: D

Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.

3. What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

• A. Proteinuria
• B. Daily weight
• C. Specific gravity
• D. Intake and output

Correct answer: B

Rationale: Daily weight is the most accurate measure of fluid balance in children with acute glomerulonephritis, as it reflects changes in body fluid status more reliably than other measures like proteinuria or specific gravity.

4. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

5. The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?

• A. 2 to 3 years
• B. 4 to 5 years
• C. 6 to 7 years
• D. 8 to 9 years

Correct answer: B

Rationale: The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.

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