Nursing Elites

1. The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

• A. Poor appetite
• B. Reduction of edema
• C. Restriction to bed rest
• D. Increased potassium intake

Correct answer: B

Rationale: The weight loss is most likely due to the reduction of edema, as glomerulonephritis often causes fluid retention that resolves with treatment, leading to significant weight loss.

2. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?

• A. Strong evidence from unbiased observational studies
• B. Evidence from randomized clinical trials showed inconsistent results
• C. Consistent evidence from well-performed randomized clinical trials
• D. Evidence for at least one critical outcome from randomized clinical trials had serious flaws

Correct answer: B

Rationale: Moderate evidence typically indicates that results from randomized clinical trials were inconsistent, highlighting the need for further research to confirm findings.

3. A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?

• A. We will keep our child away from anyone who is ill.
• B. We will be sure to administer the prednisone as ordered.
• C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
• D. We understand our child will not be able to attend school, so we will arrange for homeschooling.

Correct answer: D

Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.

4. What is the most appropriate nursing action when intermittently gavage feeding a preterm infant?

• A. Allow formula to flow by gravity
• B. Avoid allowing the infant to suck on the tube
• C. Insert the tube through the nares instead of the mouth
• D. Apply gentle pressure to the syringe to deliver the formula

Correct answer: A

Rationale: The correct action when intermittently gavage feeding a preterm infant is to allow the formula to flow by gravity. This method helps prevent overfeeding and aspiration, which can occur if the formula is delivered too quickly under pressure. Choice B is incorrect as sucking on the tube can cause complications. Choice C is incorrect as the tube is typically inserted through the mouth. Choice D is incorrect as steady pressure can lead to rapid delivery of the formula, increasing the risk of complications.

5. In assessing sexual maturity levels, which tool would you expect to use?

• A. Denver II Developmental Screening
• B. Tanner staging
• C. Antibody testing
• D. Nursing process

Correct answer: B

Rationale: The correct answer is B: Tanner staging. Tanner staging is a tool specifically used to assess sexual maturity in adolescents based on the development of secondary sexual characteristics. The Tanner scale ranges from stage 1 (prepubertal) to stage 5 (adult maturity). This tool helps healthcare providers evaluate the physical development and sexual maturation of individuals. Choice A, the Denver II Developmental Screening, is used to assess developmental milestones in children. Choice C, antibody testing, is a diagnostic tool used to detect the presence of specific antibodies in the blood. Choice D, the nursing process, is a systematic method that nurses use to deliver patient-centered care, involving assessment, diagnosis, planning, implementation, and evaluation.

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