Nursing Elites

1. What condition is the most common cause of acute renal failure in children?

• A. Pyelonephritis
• B. Tubular destruction
• C. Severe dehydration
• D. Upper tract obstruction

Correct answer: C

Rationale: Severe dehydration is the most common cause of acute renal failure in children, as it leads to prerenal azotemia, which can progress to renal failure if not corrected. Other causes like pyelonephritis and tubular destruction are less common and usually secondary to other conditions.

2. What is the best indicator of fluid balance in a pediatric patient?

• A. Blood pressure
• B. Heart rate
• C. Weight
• D. Urine output

Correct answer: C

Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.

3. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

• A. Safe administration of daily enemas
• B. Necessity of firm stools to keep suture line clean
• C. Bowel training beginning as soon as the child returns home
• D. Changes in stooling patterns to report to the practitioner

Correct answer: D

Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.

4. Which data should be included in a health history?

• A. Review of systems
• B. Physical assessment
• C. Growth measurements
• D. Record of vital signs

Correct answer: A

Rationale: The review of systems is a critical part of a health history, helping to identify any symptoms or conditions that need further evaluation.

5. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?

• A. The United States is ranked last among 27 countries
• B. The United States is ranked similar to 20 other developed countries
• C. The United States is ranked in the middle of 20 other developed countries
• D. The United States is ranked highest among 27 other industrialized countries

Correct answer: A

Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.

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