Nursing Elites

1. Are most children with hypertension asymptomatic?

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: A

Rationale: The statement is true. In many cases, children with hypertension do not show any symptoms, making it challenging to diagnose them. Regular blood pressure checks are crucial to detect hypertension early, as it can have serious health implications if left untreated. Choice B is incorrect because most children with hypertension do not exhibit symptoms, hence being asymptomatic. Choices C and D are empty as they do not provide additional options.

2. How should the nurse prepare the sibling of a near-drowning accident victim who wants to see his brother in the pediatric intensive care unit, considering the child was present during the accident?

• A. Have the parents explain to the child why the sibling is so sick and inform the child that this could be the last time he sees his brother.
• B. Reassure the sibling not to cry in the child's room to avoid upsetting the ill child.
• C. If death is imminent, avoid informing the child about it and minimize involvement in care to protect the child from further trauma.
• D. Cover tubes and wires with a sheet, wash off any existing blood, and prepare him for what he will see.

Correct answer: D

Rationale: When preparing a sibling to see their brother in the pediatric intensive care unit after a near-drowning accident, it is essential to cover tubes and wires with a sheet, wash off any existing blood, and explain what the sibling will see. This approach helps the sibling understand the situation better and prepares them emotionally for the encounter, reducing potential distress and trauma. By providing information and visual preparation, the sibling can have a more controlled and less overwhelming experience when visiting their brother in the intensive care unit. Choice A is incorrect as informing the child that this could be the last time he sees his sibling may cause unnecessary distress and anxiety. Choice B is incorrect as it dismisses the sibling's emotional response, which is essential to address in a supportive manner. Choice C is incorrect as honesty and appropriate information sharing are crucial, even in difficult situations, to help the child cope effectively with the circumstances.

3. The student nurse has performed a gestational age assessment of an infant and finds the infant to be at 32 weeks. On which set of characteristics is the nurse basing this assessment?

• A. Lanugo mostly gone, little vernix remaining on the body
• B. Prominent clitoris, enlarging labia minora, patent anus
• C. Full areola, 5 to 10 mm nipple bud, pinkish-brown areola
• D. Skin opaque, cracking at wrists and ankles, no visible vessels

Correct answer: B

Rationale: The correct answer is B. At 30 to 32 weeks' gestation, the clitoris is prominent, and the labia minora are enlarging. The labia majora are small and widely separated. As gestational age increases, the labia majora increase in size. At 36 to 40 weeks, they almost cover the clitoris. At 40 weeks and beyond, the labia majora cover the labia minora and clitoris. Choices A, C, and D do not align with the characteristic features seen at 32 weeks of gestation, making them incorrect.

4. You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:

• A. hyperventilate her due to severe hypoxia.
• B. attach the AED pads after 5 minutes of high-quality CPR.
• C. perform compressions and ventilations at a ratio of 30:2.
• D. allow the chest to fully recoil between compressions.

Correct answer: D

Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.

5. Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?

• A. If your blood glucose levels are controlled, you can switch to using pills.
• B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
• C. Your body does not make insulin, so the insulin injections help to replace it.
• D. The pills work on the adult pancreas; you can switch when you are 18.

Correct answer: C

Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.

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