Nursing Elites

1. When assessing a child with suspected nephrotic syndrome, what clinical manifestation is the nurse likely to observe?

• A. Jaundice
• B. Edema
• C. Hypertension
• D. Polyuria

Correct answer: B

Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased glomerular permeability leading to the loss of proteins, particularly albumin, in the urine. This results in decreased oncotic pressure, leading to fluid shifting into the interstitial spaces and causing edema. Jaundice (Choice A) is not a typical clinical manifestation of nephrotic syndrome. Hypertension (Choice C) is more commonly associated with conditions like glomerulonephritis. Polyuria (Choice D) is not a primary symptom of nephrotic syndrome; instead, patients may have reduced urine output due to fluid retention from edema.

2. The parents of a child with asthma ask the nurse how they can help their child prevent asthma attacks. What should the nurse advise?

• A. Avoid exposure to allergens
• B. Encourage regular exercise
• C. Provide a high-protein diet
• D. Increase fluid intake

Correct answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are often triggered by allergens such as dust mites, pollen, pet dander, and mold. By minimizing the child's exposure to these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise is beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general well-being but do not specifically address asthma prevention.

3. A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

• A. Lispro
• B. Regular
• C. NPH
• D. Glargine

Correct answer: D

Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (A) and Regular (B) are rapid-acting insulins with shorter durations of action. NPH (C) is an intermediate-acting insulin with a duration of action of about 12-16 hours. Therefore, Glargine is the correct choice for the insulin with the longest duration.

4. After corrective surgery for hypertrophic pyloric stenosis (HPS), what should the nurse teach a parent to do immediately after a feeding to limit vomiting?

• A. Rock the infant.
• B. Place the infant in an infant seat.
• C. Place the infant flat on the right side.
• D. Keep the infant awake with sensory stimulation.

Correct answer: B

Rationale: After corrective surgery for hypertrophic pyloric stenosis (HPS), placing the infant in an infant seat is the correct action to take immediately after feeding to limit vomiting. This position helps keep the head elevated, reducing the risk of vomiting. Rocking the infant (Choice A) may agitate the stomach and increase the likelihood of vomiting. Placing the infant flat on the right side (Choice C) is not recommended as it does not encourage proper digestion and may increase the risk of vomiting. Keeping the infant awake with sensory stimulation (Choice D) does not address the positioning concern related to vomiting in this specific post-operative scenario.

5. The nurse is counseling a young couple who, in 2 months, are having their third baby. The nurse uses Von Bertalanffy's general system theory applied to families to analyze the family structure. Which best describes the main emphasis of this theory and its application to family dynamics?

• A. It emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components.
• B. It emphasizes the social system of the family, such as the organization or structure of the family and how the structure relates to the function.
• C. It emphasizes the developmental stages that all families go through, beginning with marriage; the longitudinal career of the family is also known as the family life cycle.
• D. It addresses the way families respond to stress and how the family copes with the stress as a group and how each individual member copes.

Correct answer: A

Rationale: Von Bertalanffy's general system theory applied to families emphasizes the family as a system with interdependent, interacting parts that endure over time to ensure the survival, continuity, and growth of its components. This perspective views the family as a dynamic entity where each member's actions and behaviors impact the overall functioning of the family unit. Choice B is incorrect because it focuses more on the social aspects of family structure rather than the systemic view provided by Von Bertalanffy's theory. Choice C is incorrect as it pertains more to the family life cycle theory, which is different from the general system theory. Choice D is incorrect as it addresses stress response within families, a concept not central to Von Bertalanffy's general system theory.

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