Nursing Elites

1. Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?

• A. Blended
• B. Nuclear
• C. Extended
• D. Binuclear

Correct answer: C

Rationale: An extended family includes relatives such as grandparents, aunts, uncles, and other extended family members living together, beyond just the nuclear family unit.

2. Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? (Select all that apply.)

• A. It is ready to be used immediately.
• B. All below
• C. There is less restriction of activity with a fistula.
• D. It produces dilation and thickening of the superficial vessels.

Correct answer: A

Rationale: A fistula typically has fewer complications, allows for greater freedom of movement, and involves natural vessel changes that improve dialysis efficiency. However, it is not ready for immediate use, which is why it may take weeks to mature before it can be used.

3. Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?

• A. Palpate another area simultaneously
• B. Ask the child not to laugh or move
• C. Begin with deeper palpation and gradually progress to superficial palpation
• D. Have the child help with palpation by placing his or her hand over the palpating hand

Correct answer: D

Rationale: Allowing the child to place their hand over the nurse's hand helps reduce the tickling sensation and increases the child's comfort during the examination.

4. In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?

• A. Neuroblastoma
• B. Nephroblastoma
• C. Leukemia
• D. Osteosarcoma

Correct answer: A

Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.

5. What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

• A. Proteinuria
• B. Daily weight
• C. Specific gravity
• D. Intake and output

Correct answer: B

Rationale: Daily weight is the most accurate measure of fluid balance in children with acute glomerulonephritis, as it reflects changes in body fluid status more reliably than other measures like proteinuria or specific gravity.

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