Nursing Elites

1. The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?

• A. Most childhood cancers affect tissues rather than organs.
• B. Childhood cancers are usually localized when found.
• C. Unlike adult cancers, childhood cancers are less responsive to treatment.
• D. The majority of childhood cancers can be prevented.

Correct answer: A

Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers may not always be localized when found. Choice C is incorrect as childhood cancers can be responsive to treatment, although treatment approaches may differ from adult cancers. Choice D is incorrect as the majority of childhood cancers cannot be prevented; however, certain risk factors can be managed to reduce the risk of developing cancer.

2. A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?

• A. Feeding problems are common in neonates.
• B. Inadequate sucking is not significant unless cyanosis is present.
• C. Ineffective sucking and swallowing may be early indications of a heart defect.
• D. Many neonates retain mucus, which can interfere with feeding for several weeks.

Correct answer: C

Rationale: Ineffective sucking and swallowing can be early signs of a heart defect like a ventricular septal defect. This is crucial information for the nurse to consider as it aligns with the infant's tentative diagnosis. Choice A is too general and does not provide specific relevance to the situation. Choice B is incorrect as inadequate sucking can indeed be significant, especially in the context of a potential heart defect. Choice D is not directly related to the potential heart defect and feeding difficulties mentioned in the scenario.

3. What is the priority nursing intervention for a child admitted to the hospital with a diagnosis of acute glomerulonephritis?

• A. Monitoring for hypertension
• B. Providing pain relief
• C. Restricting fluid intake
• D. Encouraging fluid intake

Correct answer: A

Rationale: The priority nursing intervention for a child with acute glomerulonephritis is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, leading to impaired kidney function. Hypertension is a common complication due to fluid retention and increased renin-angiotensin system activity. Monitoring for hypertension is crucial for early detection and management to prevent further kidney damage and complications. Providing pain relief (Choice B) may be required for discomfort but is not the priority. Restricting fluid intake (Choice C) may be necessary in some kidney diseases, but in acute glomerulonephritis, the focus is on monitoring and managing hypertension. Encouraging fluid intake (Choice D) is inappropriate as it can exacerbate fluid overload and hypertension in acute glomerulonephritis.

4. What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele?

• A. Positioning the infant supine with a pillow under the buttocks
• B. Covering the sac with saline-soaked nonadhesive gauze
• C. Wrapping the infant snugly in a blanket
• D. Applying a diaper to prevent fecal soiling of the sac

Correct answer: B

Rationale: The correct answer is B: Covering the sac with saline-soaked nonadhesive gauze. This intervention is essential in caring for an infant with myelomeningocele as it helps prevent infection and maintains a moist environment around the sac before surgical repair. Positioning the infant supine with a pillow under the buttocks (Choice A) may be suitable for comfort but is not directly related to managing the myelomeningocele. Wrapping the infant snugly in a blanket (Choice C) and applying a diaper (Choice D) are not recommended as they can increase the risk of infection and damage to the sac.

5. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: The correct dietary instruction for a child with GERD is to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux. While avoiding gluten may be necessary for individuals with gluten sensitivity or celiac disease, it is not a standard recommendation for GERD. Avoiding spicy foods and dairy products may help some individuals with GERD, but the most crucial dietary advice is to avoid high-fat foods.

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