Nursing Elites

1. Which medication should the nurse expect to administer to a child diagnosed with Nephrotic Syndrome to decrease proteinuria?

• A. Albumin
• B. Prednisone
• C. Penicillin
• D. Furosemide (Lasix)

Correct answer: B

Rationale: Prednisone, a corticosteroid, is the primary treatment for Nephrotic Syndrome as it helps to reduce inflammation in the kidneys and decrease proteinuria by stabilizing the glomerular filtration barrier. Albumin is a protein replacement therapy and would not directly decrease proteinuria. Penicillin is an antibiotic that treats bacterial infections and is not used to manage Nephrotic Syndrome. Furosemide is a diuretic that helps in managing fluid retention but does not specifically target proteinuria in Nephrotic Syndrome.

2. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?

• A. Child abuse
• B. Cultural practice to rid the body of disease
• C. Cultural practice to treat enuresis or temper tantrums
• D. Child discipline measure common in the Vietnamese culture

Correct answer: B

Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.

3. Where in the health history does a record of immunizations belong?

• A. History
• B. Present illness
• C. Review of systems
• D. Physical assessment

Correct answer: A

Rationale: Immunizations are part of the patient’s health history and are recorded under the history section to ensure the child is up-to-date with vaccinations.

4. 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.

5. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?

• A. High serum pH
• B. Normal serum pH
• C. Metabolic alkalosis
• D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.

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