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

• A. I need to avoid pushing or pulling on an arm or leg.
• B. I should carefully lift the baby by supporting the head and neck.
• 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 by supporting the head and neck can cause fractures in infants with osteogenesis imperfecta. Caregivers should avoid lifting infants in this manner due to the risk of injury. Choices A, C, and D demonstrate correct understanding of how to prevent injuries in infants with osteogenesis imperfecta by avoiding excessive force on the arms or legs, preventing awkward positions, and lifting the legs in a safer manner to change diapers.

3. At 2 years of age, a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience?

• A. Satisfying the child’s wishes
• B. Previous experience of hospitalization
• C. Preventing the child from being with strangers
• D. Ensuring the child still receives parental affection

Correct answer: B

Rationale: The most important factor in preparing a toddler for additional surgery is their previous experience of hospitalization. This familiarity can help reduce anxiety and fear associated with the hospital environment and medical procedures. Choice A, satisfying the child’s wishes, may not always be feasible or in the child's best interest during medical procedures. Choice C, preventing the child from being with strangers, may not address the core issue of preparing the child for surgery. Choice D, ensuring the child still receives parental affection, is important but may not directly address the preparation needed for surgery.

4. A parent of an 11-month-old infant who has a cleft palate asks the nurse why it was recommended that closure of the palate should be done before the age of 2. How should the nurse respond?

• A. “After age 2, surgery is frightening and should be avoided if possible.”
• B. “Eruption of the 2-year molars often complicates the surgical procedure.”
• C. “As your child gets older, the palate gets wider and more difficult to repair.”
• D. “Surgery should be performed before your child starts to use faulty speech patterns.”

Correct answer: D

Rationale: Closure of the cleft palate is recommended before the age of 2 to prevent the development of faulty speech patterns. Performing surgery at a younger age helps avoid speech difficulties that may arise if the repair is delayed. Choice A is incorrect as it focuses on fear, not the developmental aspect. Choice B is incorrect as the eruption of molars is not the primary reason for early surgery. Choice C is incorrect because the difficulty of repair is not solely related to the width of the palate but also to speech development.

5. 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.

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