Nursing Elites

1. Why is the specific gravity for infants lower than for older children?

• A. Infants have a greater body surface area.
• B. Infants have a higher basal metabolic rate.
• C. Infants have a greater percentage of body weight that is water.
• D. Infants' kidneys are less able to concentrate urine.

Correct answer: D

Rationale: The correct answer is D because infants' kidneys are less developed compared to older children, making them less efficient at concentrating urine. This results in a lower specific gravity in infants. The other choices do not directly explain why the specific gravity is lower in infants.

2. When providing teaching to the family of a school-age child with juvenile idiopathic arthritis, which instruction should the nurse include?

• A. Limit the child's movement of the large joints.
• B. Encourage the child to perform independent self-care.
• C. Provide the child with a soft mattress for sleeping.
• D. Schedule a 2-hour daily nap for the child in the afternoon.

Correct answer: B

Rationale: Encouraging the child to perform independent self-care is essential when managing juvenile idiopathic arthritis. This instruction helps minimize pain and stiffness in the child's joints while promoting mobility and independence. It is crucial for the child to learn self-management skills early to cope better with the condition in the long term.

3. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

4. A patient taking isotretinoin (Accutane) for acne vulgaris. Which statement indicates that the patient teaching has been effective?

• A. I should use a reliable form of birth control.
• B. I will stop taking the drug if my skin is dry.
• C. It is important to increase intake of vitamin A.
• D. I do not need to use sunblock while taking Accutane.

Correct answer: A

Rationale: The correct answer is A. Isotretinoin is highly teratogenic, which means it can cause birth defects. Therefore, it is crucial for patients, especially females of childbearing potential, to use effective forms of birth control to prevent pregnancy while taking this medication. This is a key component of patient teaching to ensure the safe use of isotretinoin. Choice B is incorrect because discontinuing isotretinoin abruptly can lead to a flare-up of acne. Choice C is incorrect because increasing vitamin A intake can be harmful due to the risk of hypervitaminosis A. Choice D is incorrect because isotretinoin makes the skin more sensitive to sunlight, so sunblock is essential to prevent sunburn and skin damage.

5. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?

• A. Hypoalbuminemia
• B. Hyperkalemia
• C. Polyuria
• D. Hyperglycemia

Correct answer: A

Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.

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