Nursing Elites

1. The nurse has completed an education program on normal communication abilities in the preschool-age child. Which statement by a participant indicates a need for further education?

• A. When my child counts numbers, it is only to 10 and we are slowly working on counting higher.
• B. I am glad to know that my 4-year-old child asking so many questions is normal.
• C. Stating his name and address is too hard for my 5-year-old child; it will be another year before he can do that.
• D. My child is finally talking in a way that most of my friends can understand her speech.

Correct answer: C

Rationale: The correct answer is C. By age 5, children should be able to state their name and address. If a child cannot do this, it may indicate a developmental delay that requires further assessment. Choices A, B, and D do not indicate a need for further education as they reflect typical developmental milestones for preschool-age children, such as gradually improving counting skills, asking many questions, and improving speech clarity over time.

2. Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?

• A. Feet and hands
• B. Bridge of nose
• C. Circumoral area
• D. Mucous membranes

Correct answer: A

Rationale: Nonpathologic cyanosis in newborns shortly after birth is typically present in the feet and hands, known as acrocyanosis. This is a normal finding due to the immature peripheral circulation in newborns. Cyanosis of the bridge of the nose, circumoral area, and mucous membranes indicates generalized cyanosis, which suggests a potential underlying distress or major abnormality. Therefore, choice A is correct as it describes the expected location for nonpathologic cyanosis in newborns, while choices B, C, and D represent areas associated with abnormal cyanosis.

3. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, "I want to go back to work, but I don't want Eric to suffer because I'll have less time with him." Which is the nurse's most appropriate answer?

• A. "I'm sure he'll be fine if you get a good babysitter."
• B. "You will need to stay home until Eric starts school."
• C. "Let's talk about the childcare options that will be best for Eric."
• D. "You should go back to work so Eric will get used to being with others."

Correct answer: C

Rationale: The best approach is to discuss childcare options that would suit Eric's needs, allowing the mother to make an informed decision without guilt or pressure.

4. Which medication should the nurse expect to administer to a child diagnosed with Nephrotic Syndrome to decrease proteinuria?

• A. Albumin
• B. Prednisone
• C. Penicillin
• D. Furosemide (Lasix)

Correct answer: B

Rationale: Prednisone, a corticosteroid, is the primary treatment for Nephrotic Syndrome as it helps to reduce inflammation in the kidneys and decrease proteinuria by stabilizing the glomerular filtration barrier. Albumin is a protein replacement therapy and would not directly decrease proteinuria. Penicillin is an antibiotic that treats bacterial infections and is not used to manage Nephrotic Syndrome. Furosemide is a diuretic that helps in managing fluid retention but does not specifically target proteinuria in Nephrotic Syndrome.

5. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

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