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. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?

• A. I need to avoid pushing or pulling on an arm or leg.
• B. I must avoid lifting the baby from under the armpits.
• C. I should not bend an arm or leg into an awkward position.
• D. We must avoid lifting the legs by the ankles to change diapers.

Correct answer: B

Rationale: Lifting the baby from under the armpits can cause fractures in infants with osteogenesis imperfecta. The correct approach is to support the baby's body and head carefully, avoiding pressure on vulnerable areas prone to fractures. Choices A, C, and D demonstrate proper awareness of caring for an infant with osteogenesis imperfecta by emphasizing caution to prevent fractures.

3. A 16-year-old is suspected of having type 1 diabetes mellitus. Which clinical manifestation may be present?

• A. moist skin
• B. weight gain
• C. fluid overload
• D. poor wound healing

Correct answer: D

Rationale: Poor wound healing is a common clinical manifestation of type 1 diabetes mellitus. High blood glucose levels in diabetes can impair the body's ability to heal wounds effectively. Choices A, B, and C are incorrect. Moist skin is not a typical clinical manifestation of type 1 diabetes; instead, skin may become dry due to dehydration. Weight gain is unlikely as type 1 diabetes is characterized by weight loss. Fluid overload is also uncommon in type 1 diabetes, which is more commonly associated with dehydration due to frequent urination.

4. When describing urticaria, what would an instructor include?

• A. It is a type IV hypersensitivity reaction.
• B. Histamine release leads to vasodilation.
• C. Wheals appear first followed by erythema.
• D. The nonpruritic rash blanches with pressure.

Correct answer: B

Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction where histamine release leads to vasodilation and the formation of characteristic wheals. Choice A is incorrect as urticaria is associated with type I hypersensitivity, not type IV. Choice C is incorrect because in urticaria, erythema typically appears before the development of wheals. Choice D is incorrect as urticaria is typically pruritic and does not blanch with pressure.

5. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?

• A. Apply warm, moist compresses
• B. Apply pressure for at least 1 minute
• C. Elevate the area above the level of the heart
• D. Begin passive range-of-motion unless the pain is severe

Correct answer: C

Rationale: Elevating the affected area above the level of the heart is the correct supportive measure for a child with hemophilia who has experienced trauma. This action helps reduce bleeding and swelling by promoting venous return and preventing further pooling of blood in the affected area. Applying warm, moist compresses (Choice A) may not be recommended as it can potentially increase bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) can be helpful for minor cuts or wounds but may not be as effective in managing bleeding in a child with hemophilia. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and cause further damage in a child with hemophilia.

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