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. What is the most common cause of shock (hypoperfusion) in infants and children?

• A. infection
• B. cardiac failure
• C. accidental poisoning
• D. severe allergic reaction

Correct answer: A

Rationale: Infection is the most common cause of shock in infants and children due to their increased susceptibility to sepsis. Infants and children have underdeveloped immune systems, making them more prone to infections that can lead to septic shock. While cardiac failure is a serious condition, it is not the most common cause of shock in this population. Accidental poisoning, though dangerous, is less common than infection in causing shock in infants and children. Severe allergic reactions can lead to anaphylactic shock, but they are not as prevalent as infections in causing shock in this age group.

3. A child is being assessed for suspected appendicitis. What clinical manifestation is the healthcare professional likely to observe?

• A. Right lower quadrant pain
• B. Left lower quadrant pain
• C. Rebound tenderness
• D. Epigastric pain

Correct answer: A

Rationale: Right lower quadrant pain is a classic symptom of appendicitis. The appendix is typically located in the right lower quadrant of the abdomen, so pain in this area is commonly associated with appendicitis. Choices B, C, and D are incorrect because left lower quadrant pain, rebound tenderness, and epigastric pain are not typical manifestations of appendicitis. Left lower quadrant pain is not associated with appendicitis since the appendix is situated in the right lower quadrant. Rebound tenderness is more commonly linked with peritonitis rather than appendicitis. Epigastric pain is not a typical presentation of appendicitis as the pain is usually localized to the right lower quadrant.

4. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?

• A. Cellular metabolism is unstable in young children.
• B. The proportion of water in the body is less than in adults.
• C. Renal function is immature in children until they reach school age.
• D. The extracellular fluid requirement per unit of body weight is greater than in adults.

Correct answer: D

Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect because cellular metabolism being unstable is not the primary explanation for the symptoms described. Choice B is incorrect as the proportion of water in the body alone does not fully explain the increased risk of dehydration in infants. Choice C is incorrect because while renal function is immature in children, it is not the most relevant factor in this scenario compared to the increased fluid requirements.

5. A child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger or worsen symptoms. Monitoring dietary habits helps identify any potential triggers and ensures proper nutrition, which can impact asthma control. Assessing sleep patterns, academic performance, or behavior at home may provide valuable information in a general health assessment, but when specifically managing asthma, dietary intake assessment is the most relevant.

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