Nursing Elites

1. The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.

• A. A family consists of parents and their offspring living together.
• B. A family is whatever the child and family say it is.
• C. A family is two or more people related or unrelated who are living together.
• D. A family is two or more genetically related persons living together with separate roles.

Correct answer: B

Rationale: Given the diversity of families in today's society, some believe that family should be defined as whatever the child and family say it is.

2. A nurse is caring for a 7-year-old child with a diagnosis of type 1 diabetes mellitus. What is the priority nursing intervention?

• A. Administering insulin as prescribed
• B. Monitoring blood glucose levels
• C. Teaching the child how to self-administer insulin
• D. Encouraging regular exercise

Correct answer: B

Rationale: The priority nursing intervention for a 7-year-old child with type 1 diabetes mellitus is to monitor blood glucose levels. This is crucial for managing and adjusting insulin therapy effectively. Administering insulin as prescribed is important, but monitoring blood glucose levels takes precedence as it guides insulin administration. Teaching the child how to self-administer insulin and encouraging regular exercise are also important aspects of diabetes management, but they are not the priority in this situation.

3. Which of the following signs or symptoms is more common in children than adults following head trauma?

• A. nausea and vomiting
• B. altered mental status
• C. tachycardia and diaphoresis
• D. changes in pupillary reaction

Correct answer: A

Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.

4. A 1-month-old girl with low-set ears and severe hypotonia has been diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?

• A. Interrupted family process related to the child's diagnosis
• B. Deficient knowledge related to the genetic disorder
• C. Grieving related to the child's poor prognosis
• D. Ineffective coping related to the stress of providing care

Correct answer: C

Rationale: The most likely nursing diagnosis for a 1-month-old girl with trisomy 18, characterized by low-set ears and severe hypotonia, is 'Grieving related to the child's poor prognosis.' Trisomy 18 is associated with a poor prognosis, and families often experience grief as they come to terms with the challenges and uncertainties associated with the condition. 'Interrupted family process' may not be as relevant since the primary focus is on the child's condition. 'Deficient knowledge related to the genetic disorder' could be important but may not be the most likely initial concern, as emotional support for the family is crucial at this point. 'Ineffective coping related to the stress of providing care' is a broad diagnosis that does not specifically address the emotional response to the child's prognosis, which is the primary concern in this case.

5. A child with a cardiac malformation associated with left-to-right shunting. What does this type of congenital disorder lead to primarily?

• 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: Left-to-right shunting in a cardiac malformation results in increased blood flow to the lungs. This increased blood flow can lead to pulmonary hypertension and heart failure if left untreated. Elevated hematocrit (Choice A) is not a characteristic directly associated with left-to-right shunting. Severe growth retardation (Choice B) is not a typical manifestation of this type of congenital disorder. Clubbing of the fingers and toes (Choice C) is more commonly seen in conditions like chronic respiratory or cardiac diseases, not specifically with left-to-right shunting and associated cardiac malformations.

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