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. After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?

• A. Notify the healthcare provider.
• B. Insert a new NG tube for feedings.
• C. Replace the NG tube to maintain gastric decompression.
• D. Leave the NG tube out as it may have been in long enough.

Correct answer: A

Rationale: The most appropriate action for the nurse to take in this situation is to notify the healthcare provider immediately. This is important as the removal of the NG tube can disrupt postoperative care, especially in terms of maintaining gastric decompression. Inserting a new NG tube without practitioner direction can be unsafe and is not within the nurse's scope of practice. Similarly, replacing the NG tube or leaving it out should be decided by the healthcare provider to ensure the infant's safety and appropriate postoperative care.

3. Which is an accurate description of homosexual (or gay-lesbian) families?

• A. A nurturing environment is lacking.
• B. The children become homosexual like their parents.
• C. The stability needed to raise healthy children is lacking.
• D. The quality of parenting is equivalent to that of nongay parents.

Correct answer: D

Rationale: Research shows that the quality of parenting in homosexual families is equivalent to that in heterosexual families, and children thrive in nurturing environments provided by same-sex parents.

4. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?

• A. Spitting up
• B. Bilious vomiting
• C. Failure to thrive
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.

5. The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?

• A. Weight loss and decreased heart rate
• B. Capillary refill of less than 2 seconds and no tears
• C. Increased skin elasticity and sunken anterior fontanel
• D. Dry mucous membranes and generally ill appearance

Correct answer: D

Rationale: Dry mucous membranes and an ill appearance are good indicators of dehydration in infants, often correlating with a fluid deficit of at least 5%. Sunken fontanels and poor skin turgor are also indicative but were not options here.

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