Nursing Elites

1. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?

• A. Slow response to chemotherapy
• B. Platelets of 150,000/mcL
• C. Leukocytes less than 10,000/mcL
• D. Leukocytes of 275,000/mcL

Correct answer: D

Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.

2. The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching?

• A. Oranges
• B. All are correct
• C. Lima beans
• D. Baked beans

Correct answer: B

Rationale: The correct answer is B: All are correct. High-fiber foods like oranges, lima beans, baked beans, and raisin bran cereal are effective in preventing constipation. Oranges are a good source of fiber, lima beans and baked beans are high in fiber content, and raisin bran cereal is also rich in fiber. Bananas, which are not listed but could be considered by some as a high-fiber food, are actually low in fiber and may not be as effective in preventing constipation. Therefore, the nurse should include all the options provided in the teaching to help prevent constipation effectively.

3. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?

• A. Indicative of maladjustment
• B. A common reaction to divorce
• C. Suggestive of a lack of adequate parenting
• D. An unusual response that indicates a need for referral

Correct answer: B

Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.

4. At what age is binocularity, the ability to fixate on one visual field with both eyes simultaneously, typically achieved?

• A. 1 month
• B. 3 to 4 months
• C. 6 to 8 months
• D. 12 months

Correct answer: B

Rationale: Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is typically achieved by the age of 3 to 4 months. Achieving binocularity at 1 month is too early for most infants as their visual system is still developing. Similarly, 6 to 8 months and 12 months are beyond the normal age range for achieving binocularity, and delayed achievement could indicate potential issues like strabismus, which may lead to visual impairment if not addressed.

5. What interventions should be implemented to maintain the skin integrity of a preterm infant born at 30 weeks?

• A. Avoid cleaning the skin
• B. Bathe the infant with sterile water
• C. Cleanse the skin with a gentle alkaline-based soap and water
• D. Thoroughly rinse the skin with plain water after bathing

Correct answer: B

Rationale: The correct intervention to maintain the skin integrity of a preterm infant born at 30 weeks is to bathe the infant with sterile water. Bathing with sterile water or a neutral pH solution is recommended to protect the delicate skin of preterm infants, which is more permeable and prone to damage. Choices A, C, and D are incorrect as avoiding cleaning the skin may lead to hygiene issues, cleansing with alkaline-based soap can be harsh on the delicate skin, and thoroughly rinsing with plain water after bathing may not be as gentle and protective for preterm infants.

Similar Questions