Nursing Elites

1. What major complication is associated with a child with chronic renal failure?

• A. Hypokalemia
• B. Metabolic alkalosis
• C. Water and sodium retention
• D. Excessive excretion of blood urea nitrogen

Correct answer: C

Rationale: Water and sodium retention is a major complication in chronic renal failure, leading to hypertension and edema. Hypokalemia and metabolic alkalosis are less common, and while BUN levels rise, retention rather than excretion is problematic in chronic renal failure.

2. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?

• A. Antibiotic treatment
• B. Adenoidectomy
• C. The insertion of tympanostomy (pressure equalizing) tubes
• D. Tonsillectomy

Correct answer: C

Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.

3. The nurse is preparing to admit a child to the hospital with a diagnosis of acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at onset for this disease is what?

• A. 2 to 4 years
• B. 5 to 7 years
• C. 8 to 10 years
• D. 11 to 13 years

Correct answer: B

Rationale: The peak age for the onset of acute poststreptococcal glomerulonephritis is typically between 5 and 7 years old. This age group is most affected due to the higher incidence of streptococcal infections in school-aged children, which can lead to this renal complication.

4. What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema?

• A. Place an ice pack on the scrotal area.
• B. Place the child in an upright sitting position.
• C. Elevate the scrotum with a rolled washcloth.
• D. Place a warm moist pack to the scrotal area.

Correct answer: C

Rationale: Elevating the scrotum with a rolled washcloth helps reduce edema by promoting fluid drainage. Ice packs are not recommended due to the risk of frostbite, and warm moist packs are not typically used for this purpose. An upright position does not specifically address the edema.

5. Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.)

• A. Disturbed concept of sexuality
• B. All are applicable
• C. Worry about themselves, parents, or siblings
• D. Expression of anger, sadness, shame, or embarrassment

Correct answer: B

Rationale: Adolescents may withdraw from social interactions, worry about the impact of the divorce, and express strong emotions such as anger or sadness.

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