Nursing Elites

1. A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?

• A. Flank pain rarely occurs in children with renal injuries.
• B. Few nonpenetrating injuries cause renal trauma in children.
• C. Kidneys are immobile, well protected, and rarely injured in children.
• D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.

Correct answer: D

Rationale: The amount of hematuria is not a reliable indicator of the severity of renal trauma, as even minor injuries can cause significant bleeding, while severe injuries may result in little or no visible blood. Renal trauma should be evaluated through imaging and clinical assessment.

2. During the nurse’s initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. What action should the nurse take?

• A. Reassess the child in 15 minutes to see if the pain rating has changed
• B. Administer the prescribed analgesic
• C. Do nothing since the child appears to be resting
• D. Ask the child’s parents if they think the child is hurting

Correct answer: B

Rationale: Pain management should be based on the child’s report of pain, regardless of their activity level. Administering the prescribed analgesic is the appropriate action. Reassessing the child in 15 minutes without providing immediate pain relief may not be in the child's best interest. Doing nothing since the child appears to be resting may lead to inadequate pain management. Asking the child’s parents if they think the child is hurting does not replace the need for direct assessment and intervention by the nurse.

3. What should the healthcare provider consider when providing support to a family whose infant has just been diagnosed with biliary atresia?

• A. The prognosis for full recovery is excellent.
• B. Death usually occurs by 6 months of age.
• C. Liver transplantation may be needed eventually.
• D. Children with surgical correction live normal lives.

Correct answer: C

Rationale: When supporting a family whose infant has been diagnosed with biliary atresia, it is important to consider that liver transplantation may be needed eventually. Biliary atresia is a serious condition where bile flow from the liver to the gallbladder is blocked or absent. While surgical interventions like the Kasai procedure can temporarily improve bile flow and delay the need for transplantation, the long-term survival often depends on liver transplantation as the child grows older. Choices A, B, and D are incorrect because the prognosis for full recovery is not excellent as biliary atresia is a chronic condition that often requires ongoing medical management, death usually does not occur by 6 months of age but the condition does require intervention, and not all children with surgical correction can live normal lives without the need for further interventions like transplantation.

4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?

• A. Suicide and cancer
• B. Suicide and homicide
• C. Drowning and cancer
• D. Homicide and heart disease

Correct answer: B

Rationale: Suicide and homicide are significant causes of death in adolescents, highlighting the need for mental health and violence prevention programs.

5. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

• A. Isotonic dehydration
• B. Hypotonic dehydration
• C. Hypertonic dehydration
• D. Hyperosmotic dehydration

Correct answer: B

Rationale: Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.

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