Nursing Elites

1. Which dietary information should the nurse include in the teaching plan for a school-age child with chronic renal failure?

• A. High in sodium
• B. Low in Vitamin D
• C. Low in phosphorus
• D. Supplementation of vitamins C, E, K

Correct answer: C

Rationale: A low-phosphorus diet is recommended for children with chronic renal failure to prevent hyperphosphatemia, which can lead to bone disease and other complications. Phosphorus is found in many processed foods and should be limited. Choices A, B, and D are incorrect because high sodium intake can lead to fluid retention and hypertension, while Vitamin D supplementation and vitamins C, E, K are not specifically indicated for dietary recommendations in chronic renal failure.

2. What amount of fluid loss occurs with moderate dehydration?

• A. <50 ml/kg
• B. 50 to 90 ml/kg
• C. <5% total body weight
• D. >15% total body weight

Correct answer: B

Rationale: Moderate dehydration is typically defined as a loss of 50 to 90 mL/kg of body weight. This amount reflects significant fluid loss that requires medical attention but is not yet severe.

3. A parent calls the hospital nursing hotline and asks, 'My 8-week-old infant cries 8 hours a day, and is hard to console. Is that normal?' What should the nurse's response be to this parent?

• A. No, call your health care provider.
• B. Let me ask you some more questions to see if there are symptoms of colic.
• C. Yes, maybe your infant is just tired.
• D. Yes, infants cry all the time at that age.

Correct answer: B

Rationale: The correct response for the nurse to provide in this situation is to ask more questions to determine if the infant is displaying symptoms of colic. Colic is a common condition in infants that can lead to prolonged crying and fussiness. It is essential to assess for other symptoms before giving advice to the parent. Choices A, C, and D are incorrect because they do not address the possibility of colic or the need for further assessment of the infant's condition.

4. What is often the initial sign of acute rheumatic fever in children?

• A. Polyarthritis
• B. Carditis
• C. Erythema marginatum
• D. Sydenham chorea

Correct answer: A

Rationale: Polyarthritis is indeed frequently the initial sign of acute rheumatic fever in children. It presents as joint pain, swelling, and redness. Carditis (inflammation of the heart), Erythema marginatum (a skin rash), and Sydenham chorea (involuntary muscle movements) are typically seen in the later stages of acute rheumatic fever and not as the initial sign.

5. In assessing sexual maturity levels, which tool would you expect to use?

• A. Denver II Developmental Screening
• B. Tanner staging
• C. Antibody testing
• D. Nursing process

Correct answer: B

Rationale: The correct answer is B: Tanner staging. Tanner staging is a tool specifically used to assess sexual maturity in adolescents based on the development of secondary sexual characteristics. The Tanner scale ranges from stage 1 (prepubertal) to stage 5 (adult maturity). This tool helps healthcare providers evaluate the physical development and sexual maturation of individuals. Choice A, the Denver II Developmental Screening, is used to assess developmental milestones in children. Choice C, antibody testing, is a diagnostic tool used to detect the presence of specific antibodies in the blood. Choice D, the nursing process, is a systematic method that nurses use to deliver patient-centered care, involving assessment, diagnosis, planning, implementation, and evaluation.

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