Nursing Elites

1. The nurse is planning an educational session with a group of school-age children. Which primary task from Erikson’s theory of psychosocial development should be addressed?

• A. Establishing trust in others
• B. Developing a sense of autonomy
• C. Developing a sense of industry
• D. Establishing a sense of identity

Correct answer: C

Rationale: In Erikson’s theory of psychosocial development, school-age children typically focus on developing a sense of industry. This stage, occurring during middle childhood, involves the desire to feel competent and productive in their skills and abilities. Choices A, B, and D are incorrect because establishing trust in others (A) is related to the first stage of Erikson's theory (trust vs. mistrust) which occurs in infancy, developing a sense of autonomy (B) is linked to the second stage (autonomy vs. shame and doubt) which occurs in early childhood, and establishing a sense of identity (D) is associated with the fifth stage (identity vs. role confusion) which occurs in adolescence.

2. A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child’s prognosis is related to what factor?

• A. Admission blood pressure
• B. Creatinine clearance
• C. Amount of protein in urine
• D. Response to steroid therapy

Correct answer: D

Rationale: The prognosis for children with MCNS is closely related to their response to steroid therapy. A favorable response to steroids usually indicates a better prognosis, while poor response may require alternative treatments and can indicate a more complicated disease course.

3. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?

• A. Increased blood pressure
• B. A sunken fontanel
• C. Decreased pulse rate
• D. Low urine specific gravity

Correct answer: B

Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.

4. Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?

• A. Prevent damage to the undescended testicle.
• B. Prevent urinary tract infections.
• C. Prevent prostate cancer.
• D. Prevent an inguinal hernia.

Correct answer: A

Rationale: The primary reason for correcting cryptorchidism through surgery is to prevent damage to the undescended testicle, which can lead to infertility and increase the risk of testicular cancer. Prevention of UTIs and prostate cancer are not the primary concerns in this context.

5. Which physiological acid-base balance complication would be most important for the nurse to assess in a patient with diarrhea?

• A. High serum pH
• B. Normal serum pH
• C. Metabolic alkalosis
• D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is metabolic acidosis. Diarrhea can lead to the loss of bicarbonate, causing an imbalance in the acid-base status of the body, specifically resulting in metabolic acidosis. High serum pH (choice A) is incorrect as diarrhea-induced bicarbonate loss would lower pH, not increase it. Normal serum pH (choice B) is not the best answer as diarrhea can disrupt the acid-base balance. Metabolic alkalosis (choice C) is an alkaline state, which is less likely to be caused by diarrhea.

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