Nursing Elites

1. What laboratory finding should the nurse expect in a child with an excess of water?

• A. Decreased hematocrit
• B. High serum osmolality
• C. High urine specific gravity
• D. Increased blood urea nitrogen (BUN)

Correct answer: A

Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.

2. Children may believe that they are responsible for their parents' divorce and interpret the separation as punishment. At which age is this most likely to occur?

• A. 1 year
• B. 4 years
• C. 8 years
• D. 13 years

Correct answer: C

Rationale: At around 8 years old, children may feel they are responsible for their parents' divorce and view it as a punishment, which can impact their emotional well-being.

3. Which situation denotes a nontherapeutic nurse-patient-family relationship?

• A. The nurse is planning to read a favorite fairy tale to a patient
• B. During shift report, the nurse is criticizing parents for not visiting their child
• C. The nurse is discussing with a fellow nurse the emotional draw to a certain patient
• D. The nurse is working with a family to find ways to decrease the family’s dependence on health care providers

Correct answer: B

Rationale: Criticizing parents or making negative comments about their involvement is nontherapeutic and can damage the nurse-patient-family relationship.

4. The nurse is conducting discharge teaching to an adolescent with a methicillin-resistant Staphylococcus aureus (MRSA) infection. What should the nurse include in the instructions?

• A. Avoid sharing of towels and washcloths
• B. All are applicable
• C. Use bleach when laundering towels and washcloths
• D. Take a daily bath or shower with an antibacterial soap

Correct answer: B

Rationale: Avoiding sharing of towels and washcloths, using bleach when laundering, and taking daily baths with antibacterial soap are critical to prevent the spread of MRSA. Cold water is not effective for laundering in these cases.

5. The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.)

• A. All are correct
• B. Anorexia
• C. Hypertension
• D. Purpura

Correct answer: A

Rationale: Hemolytic uremic syndrome (HUS) typically presents with hematuria, anorexia, hypertension, and purpura due to the hemolytic anemia, thrombocytopenia, and renal failure that characterize this condition.

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