Nursing Elites

1. The parents of a child with acute postinfectious glomerulonephritis (APIGN) ask how they will know that the condition is improving. How should the nurse respond?

• A. Your child’s urine output will increase, and the urine will become less brown in color.
• B. Your child will rest more comfortably.
• C. Your child’s appetite will decrease.
• D. Your child’s laboratory test values will show increased BUN.

Correct answer: A

Rationale: Improvement in APIGN is indicated by an increase in urine output and a change in urine color from brown (due to hematuria) to a more normal appearance. This reflects a reduction in glomerular inflammation and improved kidney function. Choice B is incorrect because resting more comfortably is not a direct indicator of kidney function improvement. Choice C is incorrect because a decrease in appetite is not typically associated with improvement in APIGN. Choice D is incorrect because an increased BUN value would suggest worsening kidney function rather than improvement.

2. Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?

• A. ''We're glad the dog can continue to sleep in our child’s room.''
• B. ''We’ll keep the plants in our child’s room dusted.''
• C. ''We’ll be sure to use the fireplace often to keep the house warm in the winter.''
• D. ''We will replace the carpet in our child’s bedroom with a hard surface.''

Correct answer: D

Rationale: The correct answer is D. Replacing carpet with hard flooring helps to reduce allergens and asthma triggers in the child’s environment. Choice A is incorrect as having a dog in the child’s room can worsen asthma symptoms due to pet dander. Choice B is incorrect because keeping plants in the child’s room can increase mold spores and allergens. Choice C is incorrect as using a fireplace can introduce smoke and other irritants into the air, worsening asthma symptoms.

3. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

• A. Female, multiple siblings, stable home life
• B. Male, high activity level, stressful home life
• C. Male, even-tempered, history of previous injuries
• D. Female, reacts negatively to new situations, no serious previous injuries

Correct answer: B

Rationale: A male child with a high activity level and a stressful home life has multiple risk factors for childhood injuries, requiring closer supervision and preventive measures.

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 nursing intervention should be included in the postoperative care of a child following a tonsillectomy?

• A. Encourage the child to blow the nose gently
• B. Notify the physician if mucus is observed in the emesis
• C. Position the child supine in the immediate postoperative period
• D. Avoid giving citrus juice

Correct answer: D

Rationale: The correct answer is D: 'Avoid giving citrus juice.' Citrus juice can irritate the throat after a tonsillectomy, so it should be avoided. Choice A is incorrect because blowing the nose gently is not a recommended intervention following a tonsillectomy. Choice B is incorrect as mucus in emesis is not uncommon postoperatively and does not necessarily require physician notification. Choice C is incorrect as positioning the child supine immediately postoperatively can increase the risk of airway obstruction and should be avoided.

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