Nursing Elites

1. The healthcare provider is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

• A. abdominal swelling
• B. weight gain
• C. hypotension
• D. increased urinary output

Correct answer: A

Rationale: Abdominal swelling is a classic presentation and often the first noticeable sign of a Wilms tumor. This occurs due to the tumor mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a presenting symptom compared to abdominal swelling. Hypotension (Choice C) is not typically associated with a Wilms tumor unless complications like bleeding or shock occur. Increased urinary output (Choice D) is not a typical finding for Wilms tumor; instead, patients may present with hematuria or urinary symptoms.

2. After the nurse has completed an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?

• A. Before starting school
• B. Within the next few months
• C. When the first deciduous teeth are lost
• D. At the next dental check-up for a family member

Correct answer: B

Rationale: The most appropriate time for a child to first visit the dentist is within the next few months after turning two years old. This visit allows the dentist to assess the child's oral health, provide guidance on proper oral hygiene practices, and establish a positive relationship with dental care. Choice A (Before starting school) is not as specific and timely as the recommended age of 2 years. Choice C (When the first deciduous teeth are lost) is not ideal as preventive dental visits should start earlier to establish good oral health habits. Choice D (At the next dental check-up for a family member) may delay the child's first dental visit, missing the opportunity for early preventive care and guidance.

3. A 6-month-old infant is diagnosed with cystic fibrosis. What explanation should the nurse provide to the parents about this condition?

• A. It is a condition affecting the respiratory and digestive systems.
• B. It is an autoimmune disorder affecting multiple organs.
• C. It is a genetic disorder that can be managed with medication.
• D. It is a condition caused by prenatal exposure to toxins.

Correct answer: A

Rationale: The correct answer is A: 'It is a condition affecting the respiratory and digestive systems.' Cystic fibrosis is a genetic disorder that primarily affects the respiratory and digestive systems. It is caused by a defective gene that leads to the production of thick and sticky mucus in these organs. This mucus can clog airways in the lungs and block the ducts in the pancreas, affecting digestion. Choice B is incorrect because cystic fibrosis is not an autoimmune disorder; it is a genetic condition. Choice C is partially correct in that cystic fibrosis is a genetic disorder, but merely managing it with medication oversimplifies the comprehensive care needed for individuals with cystic fibrosis. Choice D is incorrect as cystic fibrosis is not caused by prenatal exposure to toxins but is a genetic condition inherited from parents.

4. A healthcare professional is educating a parent group about the importance of immunizations. Which disease can be prevented by the varicella vaccine?

• A. Measles
• B. Mumps
• C. Rubella
• D. Chickenpox

Correct answer: D

Rationale: The varicella vaccine is specifically designed to prevent chickenpox. Measles, mumps, and rubella are prevented by different vaccines (MMR vaccine for measles, mumps, and rubella). Therefore, the correct answer is chickenpox (varicella). It is crucial for healthcare professionals to provide accurate information about vaccines to help ensure the health and well-being of individuals.

5. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?

• A. Deep-breathing exercises
• B. Upright positioning
• C. Coughing
• D. Chest percussion

Correct answer: B

Rationale: Upright positioning is the optimal intervention to promote maximum chest expansion in a child with Duchenne muscular dystrophy. By placing the child in an upright position, gravity can assist in expanding the chest cavity, facilitating better lung expansion and improving breathing efficiency. Deep-breathing exercises may be beneficial but are not as effective in maximizing chest expansion as upright positioning. Coughing and chest percussion focus more on airway clearance and are not directly aimed at promoting chest expansion.

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