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. A 16-year-old is suspected of having type 1 diabetes mellitus. Which clinical manifestation may be present?

• A. moist skin
• B. weight gain
• C. fluid overload
• D. poor wound healing

Correct answer: D

Rationale: Poor wound healing is a common clinical manifestation of type 1 diabetes mellitus. High blood glucose levels in diabetes can impair the body's ability to heal wounds effectively. Choices A, B, and C are incorrect. Moist skin is not a typical clinical manifestation of type 1 diabetes; instead, skin may become dry due to dehydration. Weight gain is unlikely as type 1 diabetes is characterized by weight loss. Fluid overload is also uncommon in type 1 diabetes, which is more commonly associated with dehydration due to frequent urination.

3. When compensating for increased physical activity, what should the nurse teach a child with type 1 diabetes to do?

• A. Eat more food when planning to exercise more than usual.
• B. Take oral, not injectable insulin, on days of heavy exercise.
• C. Take insulin in the morning when extra exercise is anticipated.
• D. Eat foods that contain sugar to compensate for the extra exercise.

Correct answer: A

Rationale: The correct answer is to 'Eat more food when planning to exercise more than usual.' Increased physical activity requires more energy, so additional food intake is necessary to prevent hypoglycemia. Choice B is incorrect because the method of insulin administration should not be altered based on physical activity. Choice C is incorrect as insulin timing should be consistent rather than based on anticipated exercise. Choice D is incorrect since relying on foods with sugar can lead to unstable blood sugar levels, which is not ideal for managing diabetes during exercise.

4. A nurse is providing care to a child diagnosed with sickle cell anemia. What is the priority nursing intervention?

• A. Administering pain medication
• B. Ensuring adequate hydration
• C. Providing nutritional support
• D. Monitoring vital signs

Correct answer: A

Rationale: In sickle cell anemia, pain management is a priority due to vaso-occlusive crises that cause severe pain. Administering pain medication helps alleviate discomfort and improve the child's quality of life. Ensuring adequate hydration, although important, is secondary to addressing the immediate pain issue. Providing nutritional support is beneficial for overall health but does not address the acute pain experienced. Monitoring vital signs is essential but not the immediate priority when managing pain in sickle cell anemia.

5. When assessing a 2-year-old child with abdominal pain and adequate perfusion, general guidelines include

• A. examining the child in the parent's arms
• B. palpating the painful area of the abdomen first
• C. placing the child supine and palpating the abdomen
• D. separating the child from the parent to ensure a reliable examination

Correct answer: A

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach helps reduce anxiety, provide comfort, and establish trust with the child. Palpating the painful area of the abdomen first (Choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (Choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent (Choice D) can exacerbate the child's anxiety and hinder the examination process. Therefore, examining the child in the parent's arms is the most appropriate approach in this scenario.

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