Nursing Elites

1. The healthcare provider is assessing an infant and notes that the infant's urine has a mousy or musty odor. What would the healthcare provider suspect?

• A. Maple syrup urine disease
• B. Tyrosinemia
• C. Phenylketonuria
• D. Trimethylaminuria

Correct answer: C

Rationale: Phenylketonuria (PKU) is suggested by a mousy or musty odor of the urine, caused by the inability to metabolize phenylalanine. Maple syrup urine disease (Choice A) is characterized by a sweet-smelling urine. Tyrosinemia (Choice B) presents with cabbage-like odor in the urine. Trimethylaminuria (Choice D) results in a fishy odor in the urine, breath, and sweat.

2. What are the most common signs and symptoms of leukemia related to bone marrow involvement?

• A. petechiae, infection, fatigue
• B. headache, papilledema, irritability
• C. muscle wasting, weight loss, fatigue
• D. decreased intracranial pressure, psychosis, confusion

Correct answer: A

Rationale: The correct answer is A: petechiae, infection, fatigue. In leukemia, bone marrow involvement leads to a decrease in normal blood cell production, resulting in petechiae (small red or purple spots on the skin), increased susceptibility to infections due to decreased white blood cells, and fatigue from anemia. Choices B, C, and D are incorrect because they do not directly relate to the typical signs and symptoms of leukemia with bone marrow involvement. Headache, papilledema, irritability, muscle wasting, weight loss, decreased intracranial pressure, psychosis, and confusion are not typically associated with leukemia and bone marrow involvement.

3. While assessing an 18-month-old child, a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright. What does this action indicate to the nurse?

• A. Presence of talipes equinovarus
• B. Reflective of neurologic damage
• C. Expected behavior in a toddler of this age
• D. Existence of developmental dysplasia of the hip

Correct answer: C

Rationale: The correct answer is C. Needing assistance to climb stairs is considered expected behavior for an 18-month-old toddler. At this age, children are still developing their gross motor skills, coordination, and balance, which can vary in proficiency. It is common for toddlers to be able to crawl upstairs before mastering the skill of climbing stairs upright. Options A, B, and D are incorrect because at 18 months, it is normal for children to require help and practice with climbing stairs and does not necessarily point to any specific medical conditions or developmental issues.

4. A child with a diagnosis of nephrotic syndrome is under the care of a nurse. What is the priority nursing intervention?

• A. Administering diuretics
• B. Monitoring urine output
• C. Administering corticosteroids
• D. Restricting fluid intake

Correct answer: B

Rationale: The priority nursing intervention when caring for a child with nephrotic syndrome is to monitor urine output. This is essential to assess kidney function and evaluate the effectiveness of treatment. Administering diuretics (Choice A) may be a part of the treatment plan but should not be the priority over monitoring urine output. Administering corticosteroids (Choice C) is a common treatment for nephrotic syndrome, but monitoring urine output takes precedence. Restricting fluid intake (Choice D) may be necessary in some cases, but it is not the priority intervention compared to monitoring urine output.

5. During a clinical conference with a group of nursing students, the instructor is describing burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?

• A. Skin that is reddened, dry, and slightly swollen
• B. Skin appearing wet with significant pain
• C. Skin with blistering and swelling
• D. Skin that is leathery and dry with some numbness

Correct answer: D

Rationale: Full-thickness burns are characterized by a leathery, dry appearance with numbness due to nerve damage. Choice A describes characteristics of superficial burns, which are not full-thickness. Choice B describes characteristics of partial-thickness burns with intact blisters, not full-thickness burns. Choice C describes characteristics of partial-thickness burns with blistering and swelling, not full-thickness burns.

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