Nursing Elites

1. A 3-year-old child, previously potty-trained, becomes a bed-wetter again during a hospital stay. Which explanation should the nurse provide to the parents?

• A. “Your child is no longer potty-trained and will need to be retrained when she goes home.”
• B. “The child may have developed a bladder infection in the hospital. I will notify the doctor.”
• C. “Preschool children may regress in their behaviors when they are ill in the hospital but should return to normal when they go back home.”
• D. “Don’t worry about it, she is fine.”

Correct answer: C

Rationale: During a hospital stay, preschool children may exhibit regression in behaviors such as bed-wetting due to stress. It is important for parents to understand that this behavior is a common response to the hospital environment and should resolve once the child is back home. Therefore, the correct explanation for the nurse to provide to the parents is choice C. Choice A is incorrect because it inaccurately states that the child is no longer potty-trained. Choice B is incorrect as it assumes a medical issue without evidence. Choice D is incorrect as it dismisses the parents' concerns without addressing the underlying cause of the behavior.

2. The nurse is caring for a child with acute postinfectious glomerulonephritis. Which of the following best describes the pathophysiology of acute postinfectious glomerulonephritis?

• A. Occurs after a urinary tract infection
• B. Occurs after a streptococcal infection
• C. Associated with renal vascular disorders
• D. Is caused by E. coli

Correct answer: B

Rationale: The correct answer is B: 'Occurs after a streptococcal infection.' Acute postinfectious glomerulonephritis often occurs after an infection with certain strains of streptococcus bacteria, specifically group A streptococcus. The body’s immune response to the infection leads to inflammation and damage in the kidneys. Choices A, C, and D are incorrect because acute postinfectious glomerulonephritis is primarily associated with streptococcal infections, not urinary tract infections, renal vascular disorders, or E. coli.

3. The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

• A. Consuming a regular diet
• B. Increasing protein
• C. Restricting fluids
• D. Decreasing calories

Correct answer: C

Rationale: Fluid restriction is often necessary to manage severe edema associated with MCNS. Increasing protein is not typically recommended due to the risk of exacerbating proteinuria, and calorie reduction is not generally needed.

4. What is the typical presentation of pyloric stenosis in infants?

• A. Bilious vomiting
• B. Projectile vomiting
• C. Blood in stools
• D. Failure to thrive

Correct answer: B

Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.

5. When checking the intravenous (IV) site on a child, the nurse should take which action?

• A. Look at the site.
• B. Ask the child if the site hurts.
• C. Look at the site while palpating the area.
• D. Take all the tape off, assess the site, and redress.

Correct answer: C

Rationale: Looking at and palpating the IV site helps assess for signs of infiltration or infection, such as swelling, redness, or pain. Simply looking or asking the child may miss subtle signs, and removing all the tape unnecessarily disrupts the site.

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