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. The parent of a 2-year-old child is informed by the nurse that the toddler’s negativism is expected at this age. What need is this behavior meeting?

• A. Trust
• B. Attention
• C. Discipline
• D. Independence

Correct answer: D

Rationale: Negativism in toddlers commonly occurs around the age of 2 as they begin to assert their independence and autonomy. At this stage, children are exploring their own will and preferences, leading to behaviors like defiance or negativism. Independence (choice D) is the primary need being met by this behavior as toddlers strive to establish their individuality and decision-making. While trust (choice A) is crucial for forming secure attachments, it is not the main need driving negativism in this case. Seeking attention (choice B) may be a behavior exhibited by children, but it is not the fundamental need being fulfilled by negativism. Discipline (choice C) is important for setting boundaries and teaching appropriate conduct, but it is not the primary need being addressed by negativism in toddlers.

3. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?

• A. Acidosis
• B. Alkalosis
• C. Hyperkalemia
• D. Hypernatremia

Correct answer: B

Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.

4. When working with a couple at risk of bearing a child with a genetic abnormality, what is most important for the nurse to incorporate into the plan of care?

• A. Gathering information from at least three generations
• B. Informing the couple of the need for a wide range of information
• C. Maintaining the confidentiality of the information
• D. Presenting the information in a nondirective manner

Correct answer: D

Rationale: When counseling a couple at risk of genetic abnormalities, it is crucial to present information in a nondirective manner. This approach allows the couple to make informed decisions without feeling pressured or influenced. Gathering information from at least three generations (Choice A) may be relevant for genetic counseling but is not the most critical aspect in this scenario. Informing the couple of the need for a wide range of information (Choice B) is too general and does not address the specific approach needed in this situation. Maintaining the confidentiality of the information (Choice C) is important but not the top priority compared to presenting information in a nondirective manner.

5. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: D

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is to monitor for signs of infection. This is crucial to ensure that any potential infections are promptly identified and managed before surgery. Administering antibiotics, maintaining strict NPO status, and encouraging fluid intake are important interventions in various clinical situations but are not the priority in this scenario. Administering antibiotics may be part of the treatment plan but is typically prescribed by a physician. Maintaining NPO status is important to prevent complications related to anesthesia but may not directly address the specific needs of a child with appendicitis. Encouraging fluid intake is generally beneficial for hydration but may not be the primary concern before surgery for appendicitis.

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