Nursing Elites

1. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?

• A. Clay-colored stools and dark urine
• B. History of early passage of meconium in the newborn period
• C. History of chronic, progressive constipation and failure to gain weight
• D. Continual bouts of foul-smelling diarrhea

Correct answer: C

Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.

2. The healthcare provider is providing dietary teaching to the parent of a school-age child who has celiac disease. The healthcare provider should recommend that the parent offer which of the following foods to the child?

• A. Wheat bread
• B. Vanilla malt
• C. Barley soup
• D. Rice pudding

Correct answer: D

Rationale: Celiac disease requires a lifelong gluten-free diet. Foods containing gluten such as wheat, barley, and rye should be avoided. Rice pudding is a safe option as it does not contain gluten, making it a suitable choice for a child with celiac disease.

3. The healthcare provider is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the healthcare provider to recommend to keep urine acidic?

• A. Milk
• B. Grape juice
• C. Apple juice
• D. Orange juice

Correct answer: C

Rationale: To maintain the acidity of urine and potentially prevent urinary tract infections, juices such as apple or cranberry are recommended due to their ability to create an acidic environment in the urinary tract that may help inhibit bacterial growth.

4. A child with nephrotic syndrome has not experienced diuresis after a month on corticosteroids. What protocol can the nurse encourage to induce diuresis?

• A. Ibuprofen, an anti-inflammatory agent
• B. Furosemide (Lasix), a diuretic
• C. Ciprofloxacin (Cipro), an antibiotic
• D. Cyclophosphamide (Cytoxan), an immunosuppressant

Correct answer: B

Rationale: To induce diuresis in a child with nephrotic syndrome who has not responded to corticosteroids, a diuretic like Furosemide (Lasix) is appropriate. Furosemide helps increase urine production and reduce fluid retention. Ibuprofen is an anti-inflammatory agent and does not directly induce diuresis. Ciprofloxacin is an antibiotic and is not used to promote diuresis. Cyclophosphamide is an immunosuppressant, not an antisuppressant, and is not typically used to induce diuresis in nephrotic syndrome.

5. A child has Wilms' tumor and is scheduled for surgery. Which of the following actions should the nurse include in the plan of care?

• A. Palpate the child's abdomen daily for tumor size.
• B. Reposition the child frequently.
• C. Prepare the child for chemotherapy.
• D. Avoid palpating the abdomen.

Correct answer: D

Rationale: Palpating the abdomen of a child with Wilms' tumor should be avoided to prevent the risk of rupturing the tumor and spreading cancer cells. This action is crucial to maintain the child's safety and prevent potential complications before surgery.

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