Nursing Elites

1. A healthcare provider is assessing a child with suspected Kawasaki disease. What clinical manifestation is the healthcare provider likely to observe?

• A. Generalized rash
• B. Peeling skin on the hands and feet
• C. High fever
• D. Low-grade fever

Correct answer: B

Rationale: Peeling skin on the hands and feet is a characteristic clinical manifestation of Kawasaki disease, known as desquamation. This occurs during the convalescent phase of the illness. While Kawasaki disease is associated with a high fever, which is a common early sign, and can also present with other symptoms like conjunctivitis, mucous membrane changes, and lymphadenopathy, the peeling skin on the hands and feet is a classic feature that distinguishes Kawasaki disease from other conditions. Generalized rash is not a specific hallmark of Kawasaki disease, and low-grade fever is not typically associated with this condition. Therefore, the correct answer is B, peeling skin on the hands and feet, which is a key feature of Kawasaki disease.

2. A health care provider orders a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question the order?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas do not directly lead to loss of necessary nutrients. Choice C is incorrect as it focuses on emotional impact rather than physiological risks. Choice D is incorrect as shock from a sudden drop in temperature is not a common consequence of a tap water enema in this scenario.

3. Which of the following parameters would be LEAST reliable when assessing the perfusion status of a 2-year-old child with possible shock?

• A. distal capillary refill
• B. systolic blood pressure
• C. skin color and temperature
• D. presence of peripheral pulses

Correct answer: B

Rationale: Systolic blood pressure is the least reliable parameter when assessing the perfusion status of a 2-year-old child with possible shock. In pediatric patients, especially young children, blood pressure may not decrease until significant shock has already occurred, making it a late indicator of inadequate perfusion. Depending solely on systolic blood pressure to evaluate perfusion status in this age group can lead to a delay in appropriate interventions. Distal capillary refill time, skin color, and temperature changes, and the presence of peripheral pulses are more sensitive and early indicators of perfusion status in pediatric patients. Monitoring distal capillary refill provides information on peripheral perfusion, while changes in skin color and temperature can signal circulatory compromise. Evaluating the presence or absence of peripheral pulses offers insights into vascular perfusion. These parameters offer more reliable and prompt feedback on a child's perfusion status compared to systolic blood pressure.

4. A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse explain is the most important factor in the process of toilet training?

• A. Parents’ attitude towards it
• B. Child’s motivation to remain dry
• C. Child’s ability to sit independently on the toilet
• D. Parents’ commitment to work on the toilet training

Correct answer: D

Rationale: The most crucial factor in successful toilet training is the parents' commitment to consistently work with their child. While parents' attitude and willingness are important, the key is their dedication to the process. The child's motivation and ability are also significant but rely heavily on parental guidance and support. Therefore, the correct choice is the parents' commitment to work on toilet training.

5. The nurse caring for families in crisis assesses the affective function of an immigrant family consisting of a father, mother, and two school-age children. Based on Friedman's structural functional theory, what defines this family component?

• A. Meeting the love and belonging needs of each member
• B. Teaching children how to function and assume adult roles in society
• C. Ensuring the family has necessary resources with appropriate allocation
• D. Involving the provision of physical care to keep the family healthy

Correct answer: A

Rationale: In Friedman's structural functional theory, the affective function of a family involves meeting the love and belonging needs of each member. This includes emotional support, care, and connections that contribute to the overall well-being of the family unit. Choice B is incorrect as it pertains more to the socialization function of the family, where children learn societal roles. Choice C relates to the economic function of the family, ensuring resources are available and allocated appropriately. Choice D focuses on the instrumental function of the family, which involves meeting the physical needs and health of its members.

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