Nursing Elites

1. In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.)

• A. Oliguric renal failure
• B. Increased intracranial pressure
• C. Mechanical ventilation
• D. All above

Correct answer: D

Rationale: Conditions like oliguric renal failure, increased intracranial pressure, and mechanical ventilation significantly alter fluid requirements in children. These conditions either restrict fluid output or require careful fluid management to avoid worsening the condition.

2. The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?

• A. Childhood obesity is the most common nutritional problem among children
• B. Immunization rates are the same among children of different races and ethnicity
• C. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water
• D. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents

Correct answer: A

Rationale: Childhood obesity is the most common nutritional problem in children, with significant implications for long-term health, including the risk of developing chronic diseases.

3. What is an important priority in dealing with the child suspected of having Wilms tumor?

• A. Intervening to minimize bleeding
• B. Monitoring temperature for infection
• C. Ensuring the abdomen is protected from palpation
• D. Teaching parents how to manage parenteral nutrition

Correct answer: C

Rationale: The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.

4. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

• A. 1 month
• B. 2 months
• C. 3 months
• D. 4 months

Correct answer: B

Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.

5. What is an advantage of the ventrogluteal muscle as an injection site in young children?

• A. Easily accessible from many directions
• B. Free of significant nerves and vascular structures
• C. Can be used until the child reaches a weight of 9 kg (20 lb)
• D. Increased subcutaneous fat, which provides sustained drug absorption

Correct answer: B

Rationale: The ventrogluteal site is free of significant nerves and vascular structures, making it a safer choice for intramuscular injections in young children compared to other sites that may be more prone to complications.

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