Nursing Elites

1. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?

• A. The child has recently been exposed to an infectious disease
• B. The child has symptoms of a cold but no fever
• C. The child is having intermittent episodes of diarrhea
• D. The child has a disorder that causes a deficient immune system

Correct answer: D

Rationale: A compromised immune system is a contraindication for the MMRV vaccine because it is a live attenuated vaccine and could potentially cause an infection in an immunocompromised child.

2. What do the clinical manifestations of minimal change nephrotic syndrome include?

• A. Hematuria, bacteriuria, and weight gain
• B. Gross hematuria, albuminuria, and fever
• C. Hypertension, weight loss, and proteinuria
• D. Massive proteinuria, hypoalbuminemia, and edema

Correct answer: D

Rationale: Minimal change nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema due to the loss of protein in the urine. Hematuria, bacteriuria, and weight loss are not typical features of this condition.

3. What is the recommended method to assess hydration status in infants?

• A. Capillary refill time
• B. Skin turgor
• C. Urine output
• D. Mucous membranes

Correct answer: C

Rationale: The correct answer is C: Urine output. Assessing urine output is a recommended method to determine hydration status in infants. Adequate urine output indicates good hydration, while decreased urine output may suggest dehydration. Capillary refill time (Choice A) is more indicative of circulatory status rather than hydration. Skin turgor (Choice B) is a useful assessment in adults but can be less reliable in infants. Checking mucous membranes (Choice D) can provide some information on hydration, but it is not as reliable as assessing urine output in infants.

4. The nurse is providing education to the parent of a child with Beta-thalassemia. Which risk factors about the condition should the nurse include in the teaching?

• A. Hypertrophy of the thyroid
• B. Polycythemia vera
• C. Thrombocytopenia
• D. Chronic hypoxia and iron overload

Correct answer: D

Rationale: The correct answer is D: Chronic hypoxia and iron overload. Children with Beta-thalassemia often suffer from chronic hypoxia due to ineffective erythropoiesis and require frequent blood transfusions, leading to iron overload. These complications must be managed to prevent organ damage. Choices A, B, and C are incorrect. Hypertrophy of the thyroid, polycythemia vera, and thrombocytopenia are not direct risk factors associated with Beta-thalassemia. Therefore, they should not be included in the teaching regarding this condition.

5. What self-report pain rating scales can be used in children as young as 3 years of age?

• A. Poker Chip Tool
• B. Visual Analog Scale
• C. FACES Pain Rating Scale
• D. Word-Graphic Rating Scale

Correct answer: C

Rationale: The FACES Pain Rating Scale is suitable for children as young as 3 years of age. It uses facial expressions to depict different levels of pain, making it easy for young children to understand and use. The Poker Chip Tool is validated for children aged 4 and older who have a certain level of cognitive ability. The Visual Analog Scale is more appropriate for children aged 7 and above. The Word-Graphic Rating Scale, which uses descriptive words, is recommended for children in the age range of 4 to 17 years.

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