Nursing Elites

1. Melena, the passage of black, tarry stools, suggests bleeding from which source?

• A. The perianal or rectal area
• B. The upper gastrointestinal (GI) tract
• C. The lower GI tract
• D. Hemorrhoids or anal fissures

Correct answer: B

Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.

2. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?

• A. Slow response to chemotherapy
• B. Platelets of 150,000/mcL
• C. Leukocytes less than 10,000/mcL
• D. Leukocytes of 275,000/mcL

Correct answer: D

Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.

3. What changes could the school nurse implement at the school to help reduce students’ risk for developing type 2 diabetes?

• A. Increase the amount of daily physical activity.
• B. Decrease the amount of daily physical activity.
• C. Test each child’s urine monthly.
• D. Teach parents to avoid administering aspirin to their child.

Correct answer: A

Rationale: Increasing physical activity helps improve insulin sensitivity and can prevent or delay the onset of type 2 diabetes in children. Regular physical activity is a key component in managing weight and reducing the risk of chronic diseases. Decreasing physical activity (Choice B) would not be beneficial in reducing the risk of type 2 diabetes. Testing each child’s urine monthly (Choice C) is not directly related to preventing type 2 diabetes. Teaching parents to avoid administering aspirin to their child (Choice D) is important for Reye's syndrome prevention but not directly related to reducing the risk of type 2 diabetes.

4. What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

• A. Reduce blood pressure
• B. Lower serum protein levels
• C. Minimize excretion of urinary protein
• D. Increase the ability of tissue to retain fluid

Correct answer: C

Rationale: The primary objective in managing MCNS is to minimize the excretion of urinary protein, which is responsible for the hypoalbuminemia and subsequent edema in these patients.

5. The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?

• A. Gently tap over the site.
• B. Apply a cold compress to the site.
• C. Raise the extremity above the level of the body
• D. Use a rubber band as a tourniquet for 5 minutes.

Correct answer: A

Rationale: Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.

Similar Questions