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. At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?

• A. Developmentally appropriate toys
• B. Nutritious snacks served to the children
• C. Handwashing by providers after diaper changes
• D. Certified caregivers for each of the age groups at the facility

Correct answer: C

Rationale: Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.

3. What is the primary treatment goal for a child with nephrotic syndrome?

• A. Reduce proteinuria
• B. Lower blood pressure
• C. Increase urine output
• D. Prevent infections

Correct answer: A

Rationale: The correct answer is A: Reduce proteinuria. In nephrotic syndrome, the primary treatment goal is to reduce proteinuria to prevent further kidney damage. Lowering blood pressure (choice B) is important in managing some types of kidney disease but is not the primary treatment goal in nephrotic syndrome. Increasing urine output (choice C) and preventing infections (choice D) are important aspects of supportive care but are not the primary treatment goal for nephrotic syndrome.

4. Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.)

• A. Buying clothes for the patients
• B. Showing favoritism toward a patient
• C. All
• D. Spending off-duty time with patients and families

Correct answer: C

Rationale: Overinvolvement includes personal actions like buying clothes, showing favoritism, and spending off-duty time with patients, which can blur professional boundaries.

5. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?

• A. Hyperkalemia
• B. Hyperchloremia
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: D

Rationale: Excessive vomiting in pyloric stenosis leads to the loss of stomach acid (hydrochloric acid), resulting in metabolic alkalosis, not hyperkalemia, hyperchloremia, or metabolic acidosis. Metabolic alkalosis is characterized by a higher pH level in the blood due to the loss of acid and a relative increase in bicarbonate. Hyperkalemia is an elevated level of potassium in the blood and is not directly related to excessive vomiting in pyloric stenosis. Hyperchloremia is an excess of chloride in the blood, which is not typically associated with this condition. Metabolic acidosis is a condition characterized by a lower pH level in the blood, caused by an excess of acid or a loss of bicarbonate, which is not the typical complication seen in pyloric stenosis with excessive vomiting.

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