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. What should the nurse suggest to a parent asking for help with a child experiencing night terrors?

• A. Encourage the child to talk about the night terrors.
• B. Establish a bedtime routine.
• C. Allow the child to sleep with the parents.
• D. Wake the child during the night.

Correct answer: B

Rationale: Establishing a bedtime routine is the most appropriate suggestion for a parent seeking help with a child experiencing night terrors. Bedtime routines can create a sense of security and predictability for the child, potentially reducing the frequency of night terrors. Encouraging the child to talk about the night terrors (Choice A) may not be effective during the episode as the child is usually not fully awake. Allowing the child to sleep with the parents (Choice C) may inadvertently reinforce the behavior and hinder the child’s ability to learn to self-soothe. Waking the child during the night (Choice D) may disrupt the sleep cycle and exacerbate the night terrors.

3. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.

4. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

5. A child is admitted to the hospital with pneumonia. What is the priority need that must be included in the nursing plan of care for this child?

• A. Rest
• B. Exercise
• C. Nutrition
• D. Elimination

Correct answer: A

Rationale: The correct answer is Rest. When a child is admitted to the hospital with pneumonia, the priority need in the nursing plan of care is to ensure adequate rest for the child. Rest is crucial as it allows the child's body to fight the infection and recover. Choice B, Exercise, is incorrect as strenuous physical activity may further strain the child's respiratory system. Choice C, Nutrition, is important but providing rest takes precedence initially. Choice D, Elimination, is not the priority concern in this scenario compared to ensuring rest for recovery from pneumonia.

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