Nursing Elites

1. Urinary tract anomalies are frequently associated with what irregularities in fetal development?

• A. Myelomeningocele
• B. Cardiovascular anomalies
• C. Malformed or low-set ears
• D. Defects in lower extremities

Correct answer: C

Rationale: Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.

2. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

• A. The hepatitis B vaccination series should be begun at birth
• B. All are applicable
• C. Any child not vaccinated at birth should receive two doses at least 4 months apart
• D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

3. What is the most consistent and commonly used indicator of pain in infants?

• A. Increased respirations
• B. Increased heart rate
• C. Thrashing of arms and legs
• D. Facial expression of discomfort

Correct answer: D

Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.

4. What is a common sign of moderate dehydration in children?

• A. Dry mucous membranes
• B. Normal capillary refill
• C. Hyperactive bowel sounds
• D. Edema

Correct answer: A

Rationale: Dry mucous membranes are a common sign of moderate dehydration in children, indicating a loss of bodily fluids. When a child is moderately dehydrated, the mucous membranes in the mouth and nose may appear dry. This condition can occur due to various factors such as vomiting, diarrhea, or inadequate fluid intake. Normal capillary refill (choice B) is not typically associated with dehydration; it is a measure of circulatory status. Hyperactive bowel sounds (choice C) can be present in conditions like gastroenteritis but are not specific to dehydration. Edema (choice D) is the retention of fluid in the body and is not a typical sign of dehydration.

5. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

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