Nursing Elites

1. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, increasing the risk of infections. Detecting and managing infections promptly is crucial to prevent complications and improve outcomes. Providing nutritional support is important, but infection prevention takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of bleeding is relevant in leukemia due to decreased platelet count, but infection surveillance is more critical. Monitoring for signs of pain is essential, but addressing infections promptly is the priority to prevent further deterioration in the child's condition.

2. A child has been diagnosed with classic hemophilia. A nurse teaches the child’s parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?

• A. Whenever a bleed is suspected
• B. In the morning on scheduled days
• C. At bedtime while the child is lying quietly in bed
• D. On a regular schedule at the parents’ convenience

Correct answer: B

Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.

3. The healthcare provider closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?

• A. infection
• B. hypertension
• C. encephalopathy
• D. edema

Correct answer: A

Rationale: Monitoring the temperature of a child with minimal change nephrotic syndrome is crucial for detecting early signs of infection, a common complication in this condition. In nephrotic syndrome, the child's immune system is compromised, making them more susceptible to infections. Monitoring for fever or any changes in temperature can help healthcare providers intervene promptly to prevent further complications. Hypertension (choice B) is not typically associated with minimal change nephrotic syndrome. Encephalopathy (choice C) refers to brain dysfunction and is not a common complication of nephrotic syndrome. Edema (choice D) is a primary manifestation of nephrotic syndrome but is not typically monitored through temperature assessment.

4. When assessing a 10-month-old infant, what developmental milestone should the nurse expect to observe?

• A. Crawling
• B. Sitting without support
• C. Standing with assistance
• D. Pulling to a stand

Correct answer: D

Rationale: At 10 months of age, pulling to a stand is a developmental milestone that most infants can achieve. Crawling typically occurs around 6-9 months, sitting without support around 6-8 months, and standing with assistance around 7-11 months. Therefore, choices A, B, and C are not the expected developmental milestones for a 10-month-old infant.

5. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

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