Nursing Elites

1. What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

• A. Low specific gravity
• B. Decreased hemoglobin
• C. Normal platelet count
• D. Reduced serum albumin

Correct answer: D

Rationale: Reduced serum albumin is a hallmark of minimal change nephrotic syndrome (MCNS) due to massive proteinuria. This results in hypoalbuminemia, which contributes to the edema characteristic of this condition.

2. A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?

• A. Reassure the mother that this is normal at this age
• B. Recommend the mother substitute a pacifier for her thumb
• C. Assess the infant for other signs of sensory deprivation
• D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs

Correct answer: A

Rationale: Thumb sucking is a normal self-soothing behavior in infants and usually does not indicate a problem. Reassuring the mother that this is normal is the appropriate response.

3. How is family systems theory best described?

• A. The family is viewed as the sum of individual members
• B. A change in one family member cannot create a change in other members
• C. Individual family members are readily identified as the source of a problem
• D. When the family system is disrupted, change can occur at any point in the system

Correct answer: D

Rationale: Family systems theory views the family as a whole, where changes in one member affect the entire system, and changes can occur at any point within the system.

4. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

• A. Most boys in the United States can be toilet trained at age 3 years.
• B. Training can begin when he has sufficient bladder capacity.
• C. Additional surgery may be necessary to achieve continence.
• D. They should begin now because he will require additional time.

Correct answer: B

Rationale: Toilet training should begin when the child has sufficient bladder capacity and control, which may be delayed in children who have undergone surgical repairs for conditions like bladder exstrophy. Premature training can lead to frustration and setbacks.

5. The parents of a newborn with an umbilical hernia ask about treatment options. The nurse's response should be based on which knowledge?

• A. Surgery is recommended as soon as possible.
• B. The defect usually resolves spontaneously by 3 to 5 years of age.
• C. Aggressive treatment is necessary to reduce its high mortality.
• D. Taping the abdomen to flatten the protrusion is not recommended.

Correct answer: B

Rationale: The correct answer is B. Most umbilical hernias in newborns resolve on their own by 3 to 5 years of age without the need for surgical intervention, unless complications arise. Surgery is not typically recommended for umbilical hernias in newborns due to the high rate of spontaneous resolution. Aggressive treatment is not necessary as umbilical hernias are typically benign and not associated with high mortality. Taping the abdomen is not recommended as it can cause skin irritation and does not speed up the resolution of the hernia.

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