Nursing Elites

1. The healthcare provider is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?

• A. After a decade of escalation, the percentage of children living in low-income families has been declining since 2000.
• B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
• C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but there is a significant increase in African American females.
• D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.

Correct answer: B

Rationale: Choice B is the correct answer as white, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This is an important disparity in health outcomes that may be influenced by various social determinants. Choices A, C, and D are incorrect because they do not accurately describe how certain families are affected by common barriers to health care. Choice A discusses the declining percentage of children in low-income families, which is not directly related to barriers to health care. Choice C talks about overweight children and the increase in African American females but does not address access to health care. Choice D discusses the impact of health care plans on working families but does not specifically address barriers to health care access for families.

2. A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the professional determine is the last sign of heart failure?

• A. Tachypnea
• B. Tachycardia
• C. Peripheral edema
• D. Periorbital edema

Correct answer: C

Rationale: Peripheral edema is often considered the last sign of heart failure in infants and children. It indicates significant fluid retention and circulatory compromise. Tachypnea (increased respiratory rate) and tachycardia (increased heart rate) are early signs of heart failure due to inadequate cardiac output. Periorbital edema, while a sign of excess fluid, typically occurs earlier in the progression of heart failure compared to peripheral edema.

3. A child with a cardiac malformation associated with left-to-right shunting is being cared for by a nurse. What does the nurse consider to be the major characteristic of this type of congenital disorder?

• A. Elevated hematocrit
• B. Severe growth retardation
• C. Clubbing of the fingers and toes
• D. Increased blood flow to the lungs

Correct answer: D

Rationale: The major characteristic of a cardiac malformation associated with left-to-right shunting is increased blood flow to the lungs. This increased flow can lead to pulmonary hypertension and heart failure if left untreated. Elevated hematocrit (Choice A) is not a typical characteristic of this condition. Severe growth retardation (Choice B) is not directly associated with left-to-right shunting. Clubbing of the fingers and toes (Choice C) is more commonly seen in conditions involving chronic hypoxia.

4. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect to find when palpating the infant’s abdomen?

• A. A distended colon
• B. Marked tenderness around the umbilicus
• C. An olive-sized mass in the right upper quadrant
• D. Rhythmic peristaltic waves in the lower abdomen

Correct answer: C

Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS, where the hypertrophied pyloric muscle forms a palpable mass in the abdomen. Choices A, B, and D are incorrect. A distended colon is not a typical finding in HPS, marked tenderness around the umbilicus is not specific to this condition, and rhythmic peristaltic waves in the lower abdomen are not associated with HPS.

5. A child with a fever is prescribed acetaminophen. What should the nurse teach the parents about administering this medication?

• A. Administer the medication with food
• B. Measure the dose with a household spoon
• C. Measure the dose with a proper measuring device
• D. Administer the medication only when the child has a high fever

Correct answer: C

Rationale: The correct answer is to measure the dose with a proper measuring device. Using a proper measuring device ensures accurate dosing, which is crucial to avoid under or overdosing. Administering the medication with food (Choice A) is not necessary for acetaminophen. Using a household spoon (Choice B) can lead to inaccurate dosing due to variations in spoon sizes. Administering the medication only when the child has a high fever (Choice D) is not appropriate as acetaminophen can be used for fever management regardless of the fever intensity.

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