Nursing Elites

1. What is the primary goal in the treatment of a child with nephrotic syndrome?

• A. Decrease urine output
• B. Increase serum albumin
• C. Reduce proteinuria
• D. Increase blood pressure

Correct answer: C

Rationale: The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.

2. Several types of long-term central venous access devices are used. What is a benefit of using an implanted port (e.g., Port-a-Cath)?

• A. You do not need to pierce the skin for access.
• B. It is easy to use for self-administered infusions.
• C. The patient does not need to limit regular physical activity, including swimming.
• D. The catheter cannot dislodge from the port even if the child plays with the port site.

Correct answer: C

Rationale: Implanted ports like the Port-a-Cath are fully implanted under the skin, allowing the child to maintain regular physical activities, including swimming, without the risk of dislodging the catheter. Piercing the skin is still required for access, and self-administration is more complex.

3. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?

• A. This cannot be prevented
• B. Infants do not feel pain as adults do
• C. This is not a good reason for refusing
• D. A topical anesthetic can be applied

Correct answer: D

Rationale: The nurse should explain that a topical anesthetic can be applied to the injection site before the immunization to reduce discomfort.

4. What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?

• A. The medication reduces gastric acid secretion.
• B. The medication neutralizes the acid in the stomach.
• C. The medication increases the rate of gastric emptying time.
• D. The medication coats the lining of the stomach and esophagus.

Correct answer: A

Rationale: The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.

5. The clinic nurse is teaching parents about when to call the office immediately for a child with a fever. What should the nurse include in the teaching session? (Select all that apply.)

• A. The child has a stiff neck.
• B. The fever is over 40.6 C (105 F).
• C. The child is younger than 2 months.
• D. All of the above

Correct answer: D

Rationale: High fever, especially in very young infants, or the presence of a stiff neck can indicate a serious infection requiring immediate attention. A fever lasting more than 3 days also warrants medical evaluation.

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