Nursing Elites

1. What amount of fluid loss occurs with moderate dehydration?

• A. <50 ml/kg
• B. 50 to 90 ml/kg
• C. <5% total body weight
• D. >15% total body weight

Correct answer: B

Rationale: Moderate dehydration is typically defined as a loss of 50 to 90 mL/kg of body weight. This amount reflects significant fluid loss that requires medical attention but is not yet severe.

2. An anxious 12-year-old child receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, 'Is it hard to give someone an injection?' This child’s question is evidence that the child has developed which cognitive skill?

• A. Conservation
• B. Accommodation
• C. Decentering
• D. Class inclusion

Correct answer: C

Rationale: The correct answer is C: Decentering. Decentering is the ability to consider multiple aspects of a situation, which the child's question demonstrates. In this scenario, the child's question shows that she is thinking beyond her own experience and considering the difficulty or complexity of giving an injection from the nurse's perspective. Choices A, B, and D are incorrect. Conservation refers to understanding that certain properties of an object remain the same despite changes in its appearance. Accommodation is the process of adjusting existing knowledge or creating new mental categories to incorporate new information. Class inclusion involves understanding the relationship between a whole set and its subsets, which is not demonstrated in the child's question.

3. A six-year-old child is admitted to the hospital with a diagnosis of urinary tract infection. Which of these factors contribute to urinary tract infections in young children?

• A. Excessive intake of carbonated beverages.
• B. Insufficient water intake to flush the kidneys.
• C. Voiding pattern of 5-6 times a day.
• D. Infrequent voiding which results in urinary stasis.

Correct answer: D

Rationale: Infrequent voiding can lead to urinary stasis, which increases the risk of urinary tract infections by allowing bacteria to multiply in the bladder. Encouraging regular voiding and proper hydration can help prevent UTIs. Choices A, B, and C are incorrect. Excessive intake of carbonated beverages may irritate the bladder but is not a direct cause of UTIs. Insufficient water intake can concentrate urine but does not necessarily lead to infections. A voiding pattern of 5-6 times a day is within the normal range and is not associated with increased UTI risk.

4. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

• A. Initiating breast or bottle-feedings to stabilize the blood glucose level
• B. Maintaining pain management with an intravenous opioid
• C. Covering the intact bowel with a nonadherent dressing to prevent injury
• D. Performing immediate surgery

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

5. In children with Type 1 diabetes, what is a common early sign of hypoglycemia?

• A. Irritability
• B. Rapid heartbeat
• C. Confusion
• D. Sweating

Correct answer: D

Rationale: Sweating is indeed one of the earliest signs of hypoglycemia in children with Type 1 diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can lead to sweating. While irritability, rapid heartbeat, and confusion can also be seen in hypoglycemia, sweating is particularly common as a quick indicator of low blood sugar levels in children with Type 1 diabetes.

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