Nursing Elites

1. The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?

• A. Age of the child
• B. Gender of the child
• C. Family characteristics
• D. Ongoing family conflict

Correct answer: D

Rationale: The level of ongoing family conflict is the most significant factor influencing the positive or negative outcomes for children during and after a divorce

2. What is known as providing families with information on normal growth and development and nurturing child-rearing practices before the child enters that stage of development?

• A. Holistic nursing
• B. Evidence-based practice
• C. Morbidity
• D. Anticipatory guidance

Correct answer: D

Rationale: Anticipatory guidance is the process of providing parents with information about expected developmental milestones and how to address common issues that may arise during different stages of their child's growth. This proactive approach helps parents prepare for and support their child's development. Holistic nursing (choice A) refers to a comprehensive and integrated approach to healthcare that considers the whole person. Evidence-based practice (choice B) involves making clinical decisions based on the best available evidence. Morbidity (choice C) refers to the prevalence of a disease in a population.

3. Clinical manifestations of sodium excess (hypernatremia) include which signs or symptoms?

• A. Hyperreflexia
• B. Abdominal cramps
• C. Cardiac dysrhythmias
• D. Dry, sticky mucous membranes

Correct answer: D

Rationale: Hypernatremia often presents with dry, sticky mucous membranes due to dehydration. Hyperreflexia and abdominal cramps may also occur, but dry mucous membranes are more consistently observed in cases of sodium excess.

4. The parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old. How should the nurse respond?

• A. Your child probably had a crisis, and you were unaware of the symptoms.
• B. Are you sure your child has sickle cell anemia and not sickle cell trait?
• C. Affected children can be asymptomatic in early infancy because of high levels of fetal hemoglobin that inhibit sickling.
• D. Have you asked your doctor about this yet?

Correct answer: C

Rationale: The correct answer is C. Fetal hemoglobin (HbF) is present in high levels during early infancy, inhibiting sickling unlike adult hemoglobin (HbS). As the levels of HbF decrease and HbS increases, the risk of sickling and crises becomes more pronounced, typically after 6 months of age. Choice A is incorrect because it assumes the crisis went unnoticed, which is not supported by medical knowledge. Choice B is incorrect as it questions the child's diagnosis rather than explaining the phenomenon of delayed crises. Choice D is incorrect as it does not provide the parents with the necessary information regarding their query.

5. A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take?

• A. Check the urine to see if hematuria has increased.
• B. Obtain the child's blood pressure and notify the healthcare provider.
• C. Obtain serum electrolytes and send urinalysis to the laboratory.
• D. Reassure the child and encourage bed rest until the headache improves.

Correct answer: B

Rationale: Blurred vision and headache in a child with acute glomerulonephritis may indicate severe hypertension, which requires immediate assessment and intervention. Blood pressure should be checked, and the healthcare provider notified.

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