Nursing Elites

1. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

• A. Chromosome analysis will be complete in 7 days.
• B. A physical examination will be able to provide a definitive answer.
• C. Additional laboratory testing is necessary to assign the correct gender.
• D. Gender assignment involves collaboration between the parents and a multidisciplinary team.

Correct answer: D

Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.

2. What diet is most appropriate for the child with chronic renal failure (CRF)?

• A. Low in protein
• B. Low in vitamin D
• C. Low in phosphorus
• D. Supplemented with vitamins A, E, and K

Correct answer: C

Rationale: A low-phosphorus diet is important in managing chronic renal failure to prevent hyperphosphatemia and its associated complications, such as bone disease. Protein intake should be controlled but not necessarily low, and vitamin D supplementation is often required, not reduced.

3. When assessing a child with leukemia, which clinical manifestations should the nurse anticipate?

• A. Petechiae, fever, fatigue
• B. Headache, papilledema, irritability
• C. Muscle wasting, weight loss, fatigue
• D. Decreased intracranial pressure, psychosis, confusion

Correct answer: A

Rationale: The correct answer is A: Petechiae, fever, fatigue. Children with leukemia commonly present with petechiae (due to low platelet count), fever (due to infection), and fatigue (due to anemia), which are classic manifestations of the disease. Option B is incorrect because headache, papilledema, and irritability are more indicative of increased intracranial pressure, not leukemia. Option C is incorrect as muscle wasting and weight loss are not typical initial manifestations of leukemia in children. Option D is incorrect as decreased intracranial pressure, psychosis, and confusion are not commonly associated with leukemia.

4. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

5. What do mortality statistics describe?

• A. Disease occurring regularly within a geographic location
• B. The number of individuals who have died over a specific period
• C. The prevalence of specific illness in the population at a particular time
• D. Disease occurring in more than the number of expected cases in a community

Correct answer: B

Rationale: Mortality statistics describe the number of individuals who have died over a specific period, providing insight into public health concerns.

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