Nursing Elites

1. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?

• A. Mental retardation
• B. Inherited genetic factors
• C. Delayed physical growth
• D. Clubbing of the fingertips

Correct answer: C

Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.

2. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

3. A nurse is teaching the parents of a child with a diagnosis of epilepsy about seizure precautions. What should the nurse include in the teaching?

• A. Keep a diary of seizure activity
• B. Administer antiepileptic medication only when a seizure occurs
• C. Restrict the child's activities to prevent seizures
• D. Teach seizure first aid to family members

Correct answer: D

Rationale: Teaching seizure first aid to family members is crucial for ensuring the child's safety during a seizure. Keeping a diary of seizure activity (choice A) is important for tracking patterns and triggers but does not directly relate to immediate safety during a seizure. Administering antiepileptic medication only when a seizure occurs (choice B) is incorrect as medications should be given as prescribed to maintain therapeutic levels. Restricting the child's activities to prevent seizures (choice C) is not an appropriate approach as it may limit the child's quality of life without guaranteeing seizure prevention.

4. An infant is admitted to the neonatal intensive care unit (NICU) with exstrophy of the bladder. What covering should the nurse use to protect the exposed area?

• A. Loose diaper
• B. Dry gauze dressing
• C. Moist sterile dressing
• D. Petroleum jelly gauze pad

Correct answer: C

Rationale: A moist sterile dressing should be used to protect the exposed bladder tissue from infection and injury. Exstrophy of the bladder requires careful management to prevent complications such as infection. A loose diaper (Choice A) may not provide adequate protection or prevent infection. Dry gauze dressing (Choice B) may not be ideal as it could adhere to the exposed area and cause trauma upon removal. Petroleum jelly gauze pad (Choice D) may not be suitable as it can trap moisture and increase the risk of infection.

5. What is the priority nursing intervention for a child with a diagnosis of acute lymphoblastic leukemia (ALL) receiving chemotherapy?

• A. Preventing infection
• B. Administering chemotherapy
• C. Providing nutritional support
• D. Monitoring fluid intake

Correct answer: A

Rationale: The priority nursing intervention for a child with acute lymphoblastic leukemia (ALL) receiving chemotherapy is to prevent infection. Chemotherapy compromises the child's immune system, increasing susceptibility to infections. Preventing infection is crucial to avoid potential complications such as sepsis, which can be life-threatening. Administering chemotherapy is essential for treating ALL but preventing infection takes precedence due to the increased risk of infections associated with chemotherapy-induced immunosuppression. Providing nutritional support is important for overall health but preventing infections is more critical in this context. Monitoring fluid intake is significant, but the priority is to prevent infections that can have severe consequences in an immunocompromised child.

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