Nursing Elites

1. The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. The decreased aldosterone results in impaired sodium reabsorption and potassium excretion, leading to hyperkalemia. Hypernatremia (Choice A) is unlikely because sodium reabsorption is impaired. Hyperglycemia (Choice C) is not a typical lab finding in Addison's disease. Hypercalcemia (Choice D) is not associated with Addison's disease; rather, it can be seen in conditions like hyperparathyroidism.

2. A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?

• A. Preventing coronary artery aneurysms
• B. Reducing fever
• C. Improving cardiac function
• D. Preventing dehydration

Correct answer: A

Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms, which are a serious complication of this condition. Coronary artery aneurysms can lead to long-term cardiovascular issues, making prevention crucial. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is on preventing coronary artery aneurysms. Dehydration prevention is also essential but not the primary goal during the acute phase of this disease.

3. A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?

• A. Rickets
• B. Obesity
• C. Anemia
• D. Rumination

Correct answer: B

Rationale: Childhood obesity is a prevalent issue in children with Down syndrome due to factors such as decreased physical activity, slower metabolism, and potential overeating tendencies. Addressing obesity is crucial to promoting healthy lifestyles and preventing associated health complications. Rickets, a condition caused by a deficiency of vitamin D, is not commonly associated with Down syndrome. While anemia can occur in individuals with Down syndrome, obesity is a more common concern. Rumination, the regurgitation of food without nausea, is not a typical nutritional problem in children with Down syndrome.

4. After a discussion with the healthcare provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?

• A. The diameter of the aorta is enlarged.
• B. The wall between the right and left ventricles is open.
• C. It is a narrowing of the entrance to the pulmonary artery.
• D. It is a connection between the pulmonary artery and the aorta.

Correct answer: D

Rationale: Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta. In a fetus, the ductus arteriosus is a normal connection between these two vessels, allowing blood to bypass the lungs. However, it should close shortly after birth. When it remains open (patent), it leads to PDA. Choices A, B, and C do not accurately describe PDA. Choice A describes an enlarged aorta, choice B describes a ventricular septal defect, and choice C describes pulmonary stenosis, which are different cardiac conditions.

5. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

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