Nursing Elites

1. The nurse is caring for a child with acute postinfectious glomerulonephritis. Which of the following best describes the pathophysiology of acute postinfectious glomerulonephritis?

• A. Occurs after a urinary tract infection
• B. Occurs after a streptococcal infection
• C. Associated with renal vascular disorders
• D. Is caused by E. coli

Correct answer: B

Rationale: The correct answer is B: 'Occurs after a streptococcal infection.' Acute postinfectious glomerulonephritis often occurs after an infection with certain strains of streptococcus bacteria, specifically group A streptococcus. The body’s immune response to the infection leads to inflammation and damage in the kidneys. Choices A, C, and D are incorrect because acute postinfectious glomerulonephritis is primarily associated with streptococcal infections, not urinary tract infections, renal vascular disorders, or E. coli.

2. The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group?

• A. Peers
• B. Parents
• C. Siblings
• D. Teachers

Correct answer: A

Rationale: Adolescents typically identify and relate more closely to their peer group, especially during the teenage years when peer relationships become a central focus.

3. At what age is the first dose of the hepatitis A vaccine recommended to be started?

• A. 1 year
• B. 1 month
• C. 12 years
• D. It is not recommended at any age

Correct answer: A

Rationale: The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.

4. Evidence-based practice (EBP), a decision-making model, is best described as which?

• A. Using information in textbooks to guide care
• B. Combining knowledge with clinical experience and intuition
• C. Using a professional code of ethics as a means for decision-making
• D. Gathering all evidence that applies to the child’s health and family situation

Correct answer: D

Rationale: Evidence-based practice involves gathering and integrating all relevant evidence to guide clinical decision-making, ensuring that care is based on the best available research.

5. In pediatric patients, what is the primary concern with untreated vesicoureteral reflux (VUR)?

• A. Recurrent UTIs
• B. Chronic renal failure
• C. Hypertension
• D. Bladder dysfunction

Correct answer: B

Rationale: The primary concern with untreated vesicoureteral reflux (VUR) in pediatric patients is chronic renal failure. Untreated VUR can lead to this complication due to recurrent urinary tract infections and kidney damage. While recurrent UTIs (Choice A) are a common consequence of VUR, the ultimate worry is the development of chronic renal failure. Hypertension (Choice C) may occur as a result of renal damage but is not the primary concern. Bladder dysfunction (Choice D) is not the most significant consequence of untreated VUR in terms of long-term outcomes compared to chronic renal failure.

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