Nursing Elites

1. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?

• A. Increased blood pressure
• B. A sunken fontanel
• C. Decreased pulse rate
• D. Low urine specific gravity

Correct answer: B

Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.

2. Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?

• A. Feet and hands
• B. Bridge of nose
• C. Circumoral area
• D. Mucous membranes

Correct answer: A

Rationale: Nonpathologic cyanosis in newborns shortly after birth is typically present in the feet and hands, known as acrocyanosis. This is a normal finding due to the immature peripheral circulation in newborns. Cyanosis of the bridge of the nose, circumoral area, and mucous membranes indicates generalized cyanosis, which suggests a potential underlying distress or major abnormality. Therefore, choice A is correct as it describes the expected location for nonpathologic cyanosis in newborns, while choices B, C, and D represent areas associated with abnormal cyanosis.

3. An important role of the nurse in ambulatory settings and schools is the identification of communicable diseases for treatment and the prevention of spread. What is an important component related to the first period of the contagiousness of disease?

• A. Source
• B. Causative agent
• C. Prodromal stage
• D. Constitutional symptoms

Correct answer: C

Rationale: The prodromal period is the interval between the early manifestations of the disease and the time when the overt clinical syndrome is evident. Most communicable diseases are contagious during this time. Identifying the prodromal stage is crucial for early intervention and preventing the spread of the disease. While the source and causative agent are important aspects of disease control, recognizing the early signs in the prodromal stage allows the nurse to take timely actions. Constitutional symptoms occur during the active disease phase, indicating that the child has already been contagious, and early intervention opportunities may have passed.

4. A 14-year-old with chronic renal failure suddenly becomes non-compliant with the medication regimen. Which nursing intervention would most likely improve compliance?

• A. Give the child a computer-animated game that presents information on the management of chronic renal failure.
• B. Set up a meeting with some older teens who have chronic renal failure and have been managing their disease effectively.
• C. Arrange for a physician to sit down and talk to the child about the risks related to noncompliance with medications.
• D. Discuss with the child’s parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.

Correct answer: B

Rationale: Adolescents often seek guidance and support from their peers. Setting up a meeting with older teens who are effectively managing chronic renal failure can provide the 14-year-old with motivation, encouragement, and practical advice on how to handle their treatment regimen. This peer support can positively influence the non-compliant adolescent, making choice B the most likely intervention to improve compliance. Choices A and C may not address the peer influence aspect of adolescent behavior, while choice D focuses on punitive measures rather than addressing the underlying reasons for non-compliance.

5. When teaching a discipline class for parents of pre-schoolers, the nurse will be guided by which principle?

• A. Using the strictest form of punishment at the time of infraction is most effective
• B. Punishment increases unwanted behavior
• C. Discipline is to teach and gradually shift control from parents to child, promoting self-discipline
• D. Discipline and punishment are the same

Correct answer: C

Rationale: The correct principle to guide the nurse when teaching a discipline class for parents of pre-schoolers is that discipline is meant to teach and gradually shift control from parents to the child, promoting self-discipline. This approach focuses on educating children on appropriate behavior rather than solely relying on punishment. Choice A is incorrect because using the strictest punishment is not the most effective method for discipline. Choice B is incorrect because punishment can reinforce unwanted behavior if not used appropriately. Choice D is incorrect because discipline and punishment are not synonymous; discipline involves a broader aspect of teaching and guiding behavior.

Similar Questions