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 discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

• A. Advise bed rest until 1 week after the icteric phase.
• B. Teach infection control measures to family members.
• C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
• D. Reassure the mother that hepatitis A cannot be transmitted to other family members.

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

3. What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

• A. Neurogenic shock
• B. Cardiogenic shock
• C. Hypovolemic shock
• D. Anaphylactic shock

Correct answer: D

Rationale: Anaphylactic shock is a severe allergic reaction that causes massive vasodilation and increased capillary permeability, leading to rapid fluid shifts and circulatory collapse if not treated promptly. Neurogenic, cardiogenic, and hypovolemic shocks have different etiologies.

4. The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?

• A. Citrus
• B. All of the above
• C. Spicy foods
• D. Peppermint

Correct answer: B

Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.

5. The parent asks when the soft area in the infant's head will go away. What is the best response by the nurse?

• A. The area is called the anterior fontanel (fontanelle) and typically closes anytime up to 18 months of age.
• B. The area is called a fontanel (fontanelle). They remain open to allow for rapid brain growth in the first months of life.
• C. The soft spots may stay open until your infant is 2 or 3 years old.
• D. Soft spots on the infant's head should have closed by now.

Correct answer: A

Rationale: The best response by the nurse is A, as the anterior fontanel typically closes between 12-18 months of age, allowing for brain growth during infancy. Choice B is incorrect because it does not provide a specific timeframe for the closure of the fontanel. Choice C is incorrect as it suggests a later closure timeframe than usual. Choice D is incorrect as it states that the soft spots should have closed already, which is inaccurate for a 6-month-old infant.

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