Nursing Elites

1. Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?

• A. Autosomal dominant disorder in which the blood clotting factors are deficient.
• B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
• C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
• D. Autosomal recessive disorder in which the blood clotting factors are deficient.

Correct answer: B

Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.

2. For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?

• A. Appetite increases and blood pressure is normal
• B. Urinary tract infection is gone and edema subsides
• C. Generalized edema subsides and blood pressure is normal
• D. Diuresis occurs as urinary protein excretion diminishes

Correct answer: D

Rationale: The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.

3. The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?

• A. Childhood obesity is the most common nutritional problem among children
• B. Immunization rates are the same among children of different races and ethnicity
• C. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water
• D. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents

Correct answer: A

Rationale: Childhood obesity is the most common nutritional problem in children, with significant implications for long-term health, including the risk of developing chronic diseases.

4. A major reason for the development of respiratory distress syndrome in the preterm infant is:

• A. Excessive surfactant
• B. Lack of surfactant
• C. Immature immune system
• D. Lack of body fat

Correct answer: B

Rationale: The correct answer is B: Lack of surfactant. Respiratory distress syndrome (RDS) in preterm infants is primarily due to a lack of surfactant, which is crucial for keeping the lungs inflated. Without adequate surfactant, the alveoli collapse, leading to breathing difficulties. Choice A, Excessive surfactant, is incorrect as RDS is caused by an insufficient amount of surfactant. Choice C, Immature immune system, and Choice D, Lack of body fat, are not directly related to the development of respiratory distress syndrome in preterm infants.

5. An infant is diagnosed with a tracheoesophageal fistula. Which assessment finding should the nurse expect?

• A. Jaundice
• B. Hyperactive bowel sounds
• C. Absence of sucking, vomiting
• D. Coughing, with excessive secretion

Correct answer: D

Rationale: Coughing with excessive secretion is a common sign of tracheoesophageal fistula. In this condition, the connection between the trachea and esophagus allows saliva and food to enter the airways, leading to coughing and excessive secretions. Choice A, jaundice, is not typically associated with tracheoesophageal fistula. Hyperactive bowel sounds (Choice B) are more likely seen in conditions like gastroenteritis. Absence of sucking and vomiting (Choice C) is not a typical finding related to tracheoesophageal fistula.

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