Nursing Elites

1. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?

• A. Strong evidence from unbiased observational studies
• B. Evidence from randomized clinical trials showed inconsistent results
• C. Consistent evidence from well-performed randomized clinical trials
• D. Evidence for at least one critical outcome from randomized clinical trials had serious flaws

Correct answer: B

Rationale: Moderate evidence typically indicates that results from randomized clinical trials were inconsistent, highlighting the need for further research to confirm findings.

2. Why is knowledge of developmental theories useful for the nurse?

• A. Allows the nurse to know exactly what to do when caring for pediatric patients
• B. Is predictable and aids in controlling the child’s development
• C. Is a set of facts that each child follows in a prescribed method
• D. Provides a framework to guide the nurse in caring for the patient

Correct answer: D

Rationale: The correct answer is D. Understanding developmental theories helps nurses anticipate and plan appropriate care based on the child’s developmental stage. Choice A is incorrect because developmental theories provide a framework but do not dictate exact actions. Choice B is incorrect as developmental processes are not entirely predictable and are not meant to control a child’s development. Choice C is incorrect as developmental theories are not a strict set of facts that all children follow in a prescribed manner, but rather guidelines for understanding and supporting a child's growth and development.

3. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

• A. Safe administration of daily enemas
• B. Necessity of firm stools to keep suture line clean
• C. Bowel training beginning as soon as the child returns home
• D. Changes in stooling patterns to report to the practitioner

Correct answer: D

Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.

4. A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child’s prognosis is related to what factor?

• A. Admission blood pressure
• B. Creatinine clearance
• C. Amount of protein in urine
• D. Response to steroid therapy

Correct answer: D

Rationale: The prognosis for children with MCNS is closely related to their response to steroid therapy. A favorable response to steroids usually indicates a better prognosis, while poor response may require alternative treatments and can indicate a more complicated disease course.

5. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?

• A. "We will give you your shot when your mommy comes back."
• B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
• C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
• D. "This is a magic sword that will give you your medicine and make you all better."

Correct answer: C

Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.

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