Nursing Elites

1. The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect?

• A. Anemia
• B. Anorexia
• C. All are applicable
• D. Intestinal colic

Correct answer: D

Rationale: A heavy roundworm infection can cause anemia, anorexia, irritability, and an enlarged abdomen due to the worms’ effects on nutrient absorption and intestinal function.

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 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 home schooling.

Correct answer: D

Rationale: Children with MCNS in remission can usually return to school. Home schooling may be necessary only if there are complications. The other options show an understanding of proper care during remission.

3. In pediatric patients, what is the primary concern with untreated vesicoureteral reflux (VUR)?

• A. Recurrent UTIs
• B. Chronic renal failure
• C. Hypertension
• D. Bladder dysfunction

Correct answer: B

Rationale: The primary concern with untreated vesicoureteral reflux (VUR) in pediatric patients is chronic renal failure. Untreated VUR can lead to this complication due to recurrent urinary tract infections and kidney damage. While recurrent UTIs (Choice A) are a common consequence of VUR, the ultimate worry is the development of chronic renal failure. Hypertension (Choice C) may occur as a result of renal damage but is not the primary concern. Bladder dysfunction (Choice D) is not the most significant consequence of untreated VUR in terms of long-term outcomes compared to chronic renal failure.

4. What is the primary goal in the treatment of a child with nephrotic syndrome?

• A. Decrease urine output
• B. Increase serum albumin
• C. Reduce proteinuria
• D. Increase blood pressure

Correct answer: C

Rationale: The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.

5. Why is it difficult to assess a child’s dietary intake?

• A. No systematic assessment tool has been developed
• B. Biochemical analysis for assessing nutrition is expensive
• C. Families usually do not understand much about nutrition
• D. Recall of food consumption is frequently unreliable

Correct answer: D

Rationale: The correct answer is D. Recall of food intake, especially amounts eaten, is often unreliable. While systematic tools like the 24-hour recall and dietary history questionnaires exist, recall can still be challenging in accurately assessing a child's dietary intake. Choices A, B, and C are incorrect because systematic assessment tools do exist, biochemical analysis is not the primary method for dietary assessment, and families' understanding of nutrition may vary but is not the main reason for the difficulty in assessing a child's dietary intake.

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