Nursing Elites

1. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?

• A. Duvall's developmental theory
• B. Friedman's structural functional theory
• C. Von Bertalanffy's general system theory applied to families
• D. Resiliency model of family stress, adjustment, and adaptation

Correct answer: D

Rationale: The Resiliency model of family stress, adjustment, and adaptation focuses on identifying the elements of risks and protective factors that help families achieve positive outcomes. In this scenario, the nurse recognizing homelessness as a risk aligns with the resiliency model, which emphasizes how families cope and adapt in the face of stressors. Duvall's theory primarily focuses on family life cycle stages, Friedman's theory emphasizes the roles and functions within a family structure, and Von Bertalanffy's theory looks at families as complex systems rather than specifically addressing resilience in the face of stressors.

2. When assessing a child with a possible fracture, what would be the most reliable indicator for the nurse to identify?

• A. Lack of spontaneous movement
• B. Point tenderness
• C. Bruising
• D. Inability to bear weight

Correct answer: B

Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It refers to localized pain at a specific point, indicating a potential bone injury. Lack of spontaneous movement (Choice A) is non-specific and can be due to various reasons. Bruising (Choice C) may be present in fractures but is not as specific as point tenderness. Inability to bear weight (Choice D) can also be seen in fractures but may not always be present, making it less reliable compared to point tenderness.

3. A 10-year-old girl is living with a foster family. Which intervention is the priority for the child in this family structure?

• A. Determining if the child is being bullied at school
• B. Dealing with mixed expectations of parents
• C. Establishing who is the child's actual caretaker
• D. Performing a comprehensive health assessment

Correct answer: D

Rationale: Performing a comprehensive health assessment is crucial for a child living with a foster family as they may have moved between different homes, leading to incomplete medical records. This assessment helps identify any existing health issues, ensure appropriate care, and address any unmet health needs. While addressing issues like bullying or parental expectations is important, the immediate priority should be ensuring the child's overall health and well-being. Establishing the actual caretaker is also important but may not be as urgent as addressing potential health concerns.

4. A 5-year-old child is diagnosed with acute glomerulonephritis. What is a key assessment the nurse should perform?

• A. Monitor blood glucose levels
• B. Monitor respiratory rate
• C. Monitor urine output
• D. Monitor for signs of infection

Correct answer: C

Rationale: In a child diagnosed with acute glomerulonephritis, monitoring urine output is a crucial assessment. Acute glomerulonephritis affects the kidneys, leading to decreased urine output due to impaired kidney function. Monitoring urine output helps assess renal perfusion, fluid status, and kidney function. This assessment is essential in determining the effectiveness of treatment and identifying complications. Monitoring blood glucose levels (Choice A) is not directly related to acute glomerulonephritis. Respiratory rate (Choice B) may be important in other conditions but is not a key assessment for acute glomerulonephritis. Monitoring for signs of infection (Choice D) is important in general, but it is not specific to the primary issue of impaired kidney function in acute glomerulonephritis.

5. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?

• A. Cellular metabolism is unstable in young children.
• B. The proportion of water in the body is less than in adults.
• C. Renal function is immature in children until they reach school age.
• D. The extracellular fluid requirement per unit of body weight is greater than in adults.

Correct answer: D

Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect because cellular metabolism being unstable is not the primary explanation for the symptoms described. Choice B is incorrect as the proportion of water in the body alone does not fully explain the increased risk of dehydration in infants. Choice C is incorrect because while renal function is immature in children, it is not the most relevant factor in this scenario compared to the increased fluid requirements.

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