Nursing Elites

1. The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?

• A. Physiologic manifestations of renal disease
• B. The fact that adolescents have few coping mechanisms
• C. Neurologic manifestations that occur with dialysis
• D. Resentment of the control and enforced dependence imposed by dialysis

Correct answer: D

Rationale: Adolescents may feel anger and depression due to the loss of independence and control over their lives, which is imposed by the need for regular dialysis treatments. This reaction is common as they struggle with the restrictions placed on their social and personal lives.

2. Which immunization is typically administered at birth?

• A. Hepatitis B
• B. DTaP
• C. MMR
• D. Varicella

Correct answer: A

Rationale: The correct answer is A, Hepatitis B. The Hepatitis B vaccine is usually given at birth to protect against hepatitis B, a virus that can lead to chronic liver disease and liver cancer. This vaccination is crucial for newborns, especially those born to mothers who are carriers of hepatitis B. Choices B, C, and D are incorrect because DTaP (B), MMR (C), and Varicella (D) vaccines are not typically administered at birth. DTaP is given in a series starting at 2 months, MMR is usually given around 12-15 months, and Varicella is given between 12-15 months of age.

3. When discussing discipline with the mother of a 4-year-old child, which should the nurse include?

• A. Parental control should be consistent.
• B. Withdrawal of love and approval is effective at this age.
• C. Children as young as 4 years rarely need to be disciplined.
• D. One should expect rules to be followed rigidly and unquestioningly.

Correct answer: A

Rationale: Consistent parental control is crucial for effective discipline, providing clear expectations and consequences for behavior.

4. The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?

• A. Poor hygiene
• B. Constipation
• C. Urinary stasis
• D. Congenital anomalies

Correct answer: C

Rationale: Urinary stasis is the most important factor in the development of UTIs because it provides an environment for bacterial growth. While poor hygiene and congenital anomalies are contributing factors, preventing urinary stasis is key in UTI prevention.

5. After 8 weeks in the neonatal intensive care unit, Chris will soon be discharged. His parents seem apprehensive and worry that he may still be in danger. What is this considered by the nurse?

• A. A common parental reaction
• B. Suggestive of maladaptation
• C. A reason to postpone discharge
• D. Suggestive of inadequate bonding

Correct answer: A

Rationale: Parents become apprehensive and worried as the time for discharge approaches, which is a common parental reaction. They often have concerns and insecurities about caring for their infant. The worry about potential dangers is a normal adaptive response reflecting the parents' concern for their child's well-being. It is essential for healthcare providers to acknowledge these feelings and support parents in gaining confidence in caring for their infant. Choices B, C, and D are incorrect because the parents' apprehension in this context is a typical emotional response and not indicative of maladaptation, a reason to postpone discharge, or inadequate bonding.

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