Nursing Elites

1. What factor predisposes the urinary tract to infection in children?

• A. increased fluid intake
• B. short urethra in young girls
• C. prostatic secretions in males
• D. frequent emptying of the bladder

Correct answer: B

Rationale: The short urethra in young girls predisposes them to urinary tract infections. In young girls, the proximity of the urethra to the anus and the shorter urethra compared to boys make it easier for bacteria to travel up the urinary tract, increasing the risk of infection. Increased fluid intake and frequent emptying of the bladder are actually helpful in preventing urinary tract infections by flushing out bacteria. Prostatic secretions in males are not a factor in predisposing the urinary tract to infection in children.

2. When counseling a couple who suspect they could have a child with a genetic abnormality, what would be most important for the nurse to incorporate into the plan of care when working with this family?

• A. Gathering information from at least three generations
• B. Informing the family of the need for a wide range of information
• C. Maintaining the confidentiality of the information
• D. Presenting the information in a nondirective manner

Correct answer: D

Rationale: When counseling a couple about the possibility of having a child with a genetic abnormality, it is vital for the nurse to present information in a nondirective manner. This approach empowers the couple to make decisions based on their values and preferences, respecting their autonomy. Gathering information from three generations (Choice A) may not be necessary and might overwhelm the couple with unnecessary data. Informing the family about the need for a wide range of information (Choice B) is not as critical as supporting their decision-making process through a nondirective approach. While maintaining confidentiality (Choice C) is crucial, it is not the most important aspect compared to ensuring the couple can make informed choices that align with their beliefs and wishes.

3. What is the most common cause of shock (hypoperfusion) in infants and children?

• A. infection
• B. cardiac failure
• C. accidental poisoning
• D. severe allergic reaction

Correct answer: A

Rationale: Infection is the leading cause of shock in infants and children due to their heightened vulnerability to sepsis. Infants and children possess developing immune systems, rendering them more susceptible to infections that can progress to septic shock. While cardiac failure is a severe condition, it is not as commonly the primary cause of shock in this age group. Accidental poisoning, though a potential shock inducer, is less prevalent in infants and children compared to infections. Severe allergic reactions, though significant, are not as frequent as infections in precipitating shock in infants and children.

4. What are general guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion?

• A. Examining the child in the parent's arms
• B. Palpating the painful area of the abdomen first
• C. Placing the child supine and palpating the abdomen
• D. Separating the child from the parent to ensure a reliable examination

Correct answer: A

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is important to examine the child in the parent's arms. This approach helps reduce the child's anxiety, provides comfort, and can facilitate a more accurate assessment. Palpating the painful area of the abdomen first (choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent to ensure a reliable examination (choice D) can further increase anxiety and hinder the assessment process. Therefore, examining the child in the parent's arms (choice A) is the most appropriate and effective approach in this scenario.

5. While assessing a child admitted for an asthma attack, a nurse in the emergency department observes large welts and scars on the child's back. What additional information must be included in the nurse’s assessment?

• A. History of an injury
• B. Signs of child abuse
• C. Presence of food allergies
• D. Recent recovery from chickenpox

Correct answer: B

Rationale: The correct answer is B: Signs of child abuse. When a nurse observes large welts and scars on a child, it raises concern for possible child abuse. It is crucial for the nurse to assess further for signs of abuse, document findings, and report appropriately to protect the child. Choice A, history of an injury, is not specific to potential abuse and may not provide insight into the current situation. Choice C, presence of food allergies, is not directly related to the observed welts and scars. Choice D, recent recovery from chickenpox, is also unrelated to the signs of abuse and does not impact the immediate assessment of the child's safety.

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