Nursing Elites

1. Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?

• A. Bacteriuria and increased specific gravity
• B. Hematuria and proteinuria
• C. Proteinuria and decreased specific gravity
• D. Bacteriuria and hematuria

Correct answer: B

Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, the presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.

2. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?

• A. Administer aspirin for pain.
• B. Avoid administering NSAIDs.
• C. Restrict physical activities.
• D. Apply heat to joints.

Correct answer: B

Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.

3. A nurse is caring for a school-age child with primary nephrotic syndrome who is taking prednisone. After 1 week of treatment, which manifestation indicates to the nurse that the medication is effective?

• A. Decreased edema
• B. Increased abdominal girth
• C. Decreased appetite
• D. Increased protein in the urine

Correct answer: A

Rationale: In a child with nephrotic syndrome, the presence of edema is due to fluid retention caused by protein loss in the urine. Prednisone, a corticosteroid, helps reduce inflammation and decrease the loss of protein in the urine, leading to a decrease in edema. Therefore, decreased edema is an indication that the prednisone treatment is effective in managing the nephrotic syndrome. Increased abdominal girth would indicate fluid retention and worsening of the condition. Decreased appetite is a nonspecific symptom and not a direct indicator of prednisone efficacy. Increased protein in the urine would indicate ongoing renal impairment and the ineffectiveness of the treatment.

4. The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'? What is the nurse's best response?

• A. They are going to fix you up 'down there'.
• B. They will move your testicle from your abdomen to your scrotum.
• C. What do you think your doctor is going to do?
• D. You shouldn't worry. Your doctor knows exactly what to do.

Correct answer: C

Rationale: The nurse should encourage the child to express his thoughts and feelings about the upcoming surgery. This approach helps the child feel heard and understood while providing an opportunity to address any misconceptions or fears. By asking the child what he thinks the doctor will do, the nurse engages the child in a conversation that can help alleviate anxiety and build trust. School-age children often have fears related to bodily harm, and open communication can help alleviate such concerns. Choices A and D do not encourage open communication or address the child's concerns directly. Choice B provides too much detail that may overwhelm the child and is not age-appropriate for a 6-year-old.

5. Which statement best reflects the role of the therapeutic relationship in fostering positive behaviors in children?

• A. It may be used as an intervention strategy to help a child with positive behaviors
• B. The relationship with parents or teachers is more important
• C. It is not essential for the child's behaviors
• D. Children will not pay attention to the therapist

Correct answer: A

Rationale: A strong therapeutic relationship can significantly influence the development of positive behaviors in children. When a child feels connected, understood, and supported by a therapist, it can lead to better outcomes in promoting positive behaviors and emotional well-being.

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