Nursing Elites

1. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

• A. I will make sure he gets his measles vaccine as soon as he gets home.
• B. He can stop taking his medication next week.
• C. I should check his urine for protein when he goes to the bathroom.
• D. He should eat a low-protein diet for the next few weeks.

Correct answer: C

Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.

2. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?

• A. Applying a diaper to prevent contamination of the sac
• B. Positioning the newborn in a side-lying position
• C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
• D. Positioning the newborn in a prone position

Correct answer: D

Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.

3. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?

• A. Infection
• B. Urinary retention
• C. Easy bruising
• D. Hypoglycemia

Correct answer: A

Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.

4. A child with croup has an increased PCO2, a decreased pH, and a normal HCO3 blood gas value. Which finding does the nurse report to the healthcare provider based on these data?

• A. Uncompensated metabolic alkalosis
• B. Uncompensated metabolic acidosis
• C. Uncompensated respiratory acidosis
• D. Uncompensated respiratory alkalosis

Correct answer: C

Rationale: The blood gas values indicate uncompensated respiratory acidosis. In respiratory acidosis, there is an increased PCO2, decreased pH, and a normal HCO3 level. This condition requires immediate attention to address the underlying respiratory problem causing the acidosis.

5. Which statement best describes the recommended approach to increase participation as the focus of intervention with children and youth?

• A. Remediate areas of concern and the child's limitations
• B. Intervene with family and friends to interact differently with the child
• C. Promote the child's strengths and allow the child to accommodate challenges
• D. Evaluate the child's areas of competence and achievement, along with challenges

Correct answer: D

Rationale: The recommended approach to intervention with children and youth focuses on evaluating the child's areas of competence and achievement, along with challenges. By understanding the child's strengths and competencies, interventions can be tailored to build upon these existing positive attributes. This approach fosters a positive self-image and encourages further development by capitalizing on the child's strengths.

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