Nursing Elites

1. When planning care for a child with a urinary tract infection, the nurse should give priority to which treatment measure?

• A. Provide adequate nutrition to prevent dehydration.
• B. Administer ordered antibiotics on schedule.
• C. Prevent enuresis.
• D. Restrict fluid.

Correct answer: B

Rationale: Administering antibiotics on schedule is crucial in treating a UTI effectively and preventing complications. Antibiotics help to eliminate the infection-causing bacteria from the urinary tract. While maintaining adequate nutrition and hydration are important aspects of care, the priority in a UTI is to target the infection with antibiotics. Preventing enuresis (bedwetting) is not directly related to the treatment of the infection. Fluid restriction is not recommended in the management of a UTI; in fact, encouraging adequate fluid intake helps flush out bacteria from the urinary tract.

2. A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

• A. Careful bathing and handling
• B. Monitoring of behavioral status
• C. Maintenance of strict isolation
• D. Administration of packed red blood cells

Correct answer: A

Rationale: The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.

3. At which age can most infants sit steadily unsupported?

• A. 4 months
• B. 6 months
• C. 8 months
• D. 12 months

Correct answer: C

Rationale: Most infants can sit steadily without support by 8 months, indicating advanced gross motor skill development.

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 mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils and adenoids complains that he has begun sucking his thumb again. Which defense mechanism should the nurse include when responding to the mother?

• A. Repression
• B. Regression
• C. Rationalization
• D. Fantasy

Correct answer: B

Rationale: The correct answer is B: Regression. Regression is a common defense mechanism where a child reverts to an earlier stage of development, such as thumb-sucking, to cope with stress. In this scenario, the 6-year-old boy is using thumb-sucking (a behavior typical of earlier developmental stages) as a way to deal with the stress of surgery. Repression (choice A) involves unconsciously blocking out thoughts or feelings, which is not applicable in this case. Rationalization (choice C) is a defense mechanism where illogical or unreasonable explanations are provided to justify behavior, which is not relevant here. Fantasy (choice D) refers to the use of imagination to escape from reality, which is also not the appropriate defense mechanism for the situation described.

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