Nursing Elites

1. A toddler has minimal change nephrotic syndrome (MCNS) and 3+ pitting edema. Which intervention should the nurse include in the plan of care?

• A. Encourage an increased fluid intake for the toddler
• B. Place the child in an Airborne infection isolation room
• C. Increase the toddler's dietary sodium intake
• D. Administer corticosteroids to the toddler

Correct answer: D

Rationale: In managing minimal change nephrotic syndrome (MCNS) in children with pitting edema, corticosteroids are the mainstay of treatment. Corticosteroids help reduce inflammation and decrease proteinuria, addressing the underlying cause of MCNS. Therefore, the nurse should prioritize administering the prescribed corticosteroids to the toddler as part of the plan of care.

2. Which statement is not a principle of family-centered care?

• A. Respect family autonomy
• B. Provide flexible services
• C. Collaborate with family members
• D. Set strict rules for families to follow

Correct answer: D

Rationale: Family-centered care focuses on respecting family autonomy, providing flexible services, and collaborating with family members to ensure individualized care. Imposing strict rules contradicts the core principles of family-centered care, which prioritize partnership, communication, and shared decision-making between healthcare providers and families. Therefore, setting strict rules for families to follow goes against the collaborative and individualized nature of family-centered care, making it the statement that is not a principle of this approach.

3. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?

• A. Inflamed throat with exudate
• B. Purulent eye drainage
• C. Dry, hacking cough
• D. Koplik spots on buccal mucosa

Correct answer: C

Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.

4. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

5. Which is the priority nursing assessment when providing care for an infant at risk for dehydration?

• A. Urine output
• B. Urine specific gravity
• C. Vital signs
• D. Daily weight

Correct answer: D

Rationale: The correct answer is Daily weight. Daily weight is a crucial assessment in infants at risk for dehydration because changes in weight can indicate fluid balance and dehydration status. It is essential to monitor daily weight to promptly identify and manage dehydration in infants.

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