Nursing Elites

1. What is the primary treatment for Kawasaki disease?

• A. Corticosteroids
• B. Intravenous immunoglobulin
• C. Antibiotics
• D. Antivirals

Correct answer: B

Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.

2. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?

• A. Slow response to chemotherapy
• B. Platelets of 150,000/mcL
• C. Leukocytes less than 10,000/mcL
• D. Leukocytes of 275,000/mcL

Correct answer: D

Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.

3. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

• A. Dilating the stoma
• B. Assessing bowel function
• C. Limitation of physical activities
• D. Measures to prevent prolapse of the rectum

Correct answer: B

Rationale: Postoperative teaching should focus on assessing bowel function to ensure the colostomy is functioning properly. This includes monitoring stool output, color, consistency, and signs of infection or blockage. Choice A, dilating the stoma, is not recommended without healthcare provider guidance, as it can lead to complications. Choice C, limitation of physical activities, may not be as crucial immediately after colostomy creation. Choice D, measures to prevent prolapse of the rectum, is more relevant for conditions like rectal prolapse and not specifically for a colostomy.

4. What is typically the first sign of puberty in females?

• A. Breast development
• B. Menarche
• C. Pubic hair growth
• D. Axillary hair growth

Correct answer: A

Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.

5. A new mom is instructed to have her toddler brush his teeth every night after dinner. This is an example of __________ which increases the toddler’s sense of security and self-mastery.

• A. Negativism
• B. Diversionary activity
• C. Critical play
• D. Ritualism

Correct answer: D

Rationale: The correct answer is D, Ritualism. Establishing routines like brushing teeth every night after dinner helps toddlers feel secure and in control. Choice A, Negativism, refers to a child's oppositional behavior. Choice B, Diversionary activity, involves redirecting attention to something else. Choice C, Critical play, does not relate to the scenario of establishing a routine for the toddler.

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