Nursing Elites

1. The healthcare provider is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?

• A. After a decade of escalation, the percentage of children living in low-income families has been declining since 2000.
• B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
• C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but there is a significant increase in African American females.
• D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.

Correct answer: B

Rationale: Choice B is the correct answer as white, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This is an important disparity in health outcomes that may be influenced by various social determinants. Choices A, C, and D are incorrect because they do not accurately describe how certain families are affected by common barriers to health care. Choice A discusses the declining percentage of children in low-income families, which is not directly related to barriers to health care. Choice C talks about overweight children and the increase in African American females but does not address access to health care. Choice D discusses the impact of health care plans on working families but does not specifically address barriers to health care access for families.

2. When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, what does this decision indicate?

• A. The newborn has no rights.
• B. It is the same as euthanasia.
• C. It is illegal professional practice.
• D. The newborn is being allowed to die.

Correct answer: D

Rationale: When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, it means that aggressive interventions will not be pursued, allowing the newborn to die naturally. This decision is legal and ethical, respecting the principle of non-maleficence by avoiding unnecessary suffering. Choice A is incorrect because all individuals, including newborns, have rights, but the decision to withhold extraordinary care is based on ethical considerations. Choice B is incorrect as withholding care is not the same as euthanasia, which involves actively ending life. Choice C is incorrect as long as the decision is made within legal and ethical boundaries, it is not considered illegal professional practice.

3. The healthcare provider closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?

• A. infection
• B. hypertension
• C. encephalopathy
• D. edema

Correct answer: A

Rationale: Monitoring the temperature of a child with minimal change nephrotic syndrome is crucial for detecting early signs of infection, a common complication in this condition. In nephrotic syndrome, the child's immune system is compromised, making them more susceptible to infections. Monitoring for fever or any changes in temperature can help healthcare providers intervene promptly to prevent further complications. Hypertension (choice B) is not typically associated with minimal change nephrotic syndrome. Encephalopathy (choice C) refers to brain dysfunction and is not a common complication of nephrotic syndrome. Edema (choice D) is a primary manifestation of nephrotic syndrome but is not typically monitored through temperature assessment.

4. The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What should the nurse explain about exercise in type 1 diabetes?

• A. Exercise will increase blood glucose levels
• B. Exercise should be restricted
• C. Extra snacks are needed before exercise
• D. Extra insulin is required during exercise

Correct answer: C

Rationale: In type 1 diabetes, extra snacks are needed before exercise to prevent hypoglycemia. It is important to provide additional carbohydrates to maintain blood glucose levels during physical activity. Choices A, B, and D are incorrect. Exercise typically lowers blood glucose levels in individuals with diabetes; however, proper management and adjustments in insulin and food intake are necessary to prevent hypoglycemia. Exercise should not be restricted in individuals with type 1 diabetes but should be planned in coordination with healthcare providers to ensure safety and optimal glucose control. While some individuals may need adjustments in insulin dosages during exercise, the general statement that extra insulin is required during exercise in type 1 diabetes is not accurate.

5. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?

• A. It limits the chance of vomiting.
• B. It allows the feeding to be administered rapidly.
• C. The energy that would have been expended on sucking is conserved.
• D. The quantity of nutritional liquid can be regulated better than with a bottle.

Correct answer: C

Rationale: The correct answer is C: 'The energy that would have been expended on sucking is conserved.' Gavage feedings are necessary for infants with congenital heart defects as they help conserve the infant’s energy by eliminating the need for sucking, which can be taxing for infants with cardiac issues. Choice A is incorrect because gavage feedings are not primarily used to limit vomiting. Choice B is incorrect as the speed of administration is not the main reason for gavage feedings in this case. Choice D is incorrect because the regulation of the quantity of nutritional liquid is not the primary rationale for gavage feedings in infants with congenital heart defects.

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