Nursing Elites

1. The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made?

• A. "I am glad there will be no disruption in my lifestyle."
• B. "I don’t think children really want to live in a two-parent home."
• C. "I realize there may be power conflicts bringing two households together."
• D. "I understand contact between grandparents should be kept to a minimum."

Correct answer: C

Rationale: Recognizing the potential for power conflicts when blending two households indicates an understanding of the complexities in reconstituted families.

2. A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

• A. Careful bathing and handling
• B. Monitoring of behavioral status
• C. Maintenance of strict isolation
• D. Administration of packed red blood cells

Correct answer: A

Rationale: The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.

3. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

• A. 50th percentile
• B. 75th percentile
• C. 80th percentile
• D. 95th percentile

Correct answer: D

Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.

4. In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.)

• A. Oliguric renal failure
• B. Increased intracranial pressure
• C. Mechanical ventilation
• D. All above

Correct answer: D

Rationale: Conditions like oliguric renal failure, increased intracranial pressure, and mechanical ventilation significantly alter fluid requirements in children. These conditions either restrict fluid output or require careful fluid management to avoid worsening the condition.

5. Parents of a preschool child ask the nurse, "Should we set rules for our child as part of a discipline plan?" Which is an accurate response by the nurse?

• A. It is best to delay the punishment if a rule is broken.
• B. The child is too young for rules. At this age, unrestricted freedom is best.
• C. It is best to set the rules and reason with the child when the rules are broken.
• D. Set clear and reasonable rules and expect the same behavior regardless of the circumstances.

Correct answer: D

Rationale: Clear and reasonable rules provide structure and help children understand expectations, promoting consistent behavior and discipline.

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