Nursing Elites

1. What is the primary treatment for minimal change nephrotic syndrome?

• A. corticosteroids
• B. antihypertensive agents
• C. long-term diuretics
• D. increased fluids to promote diuresis

Correct answer: A

Rationale: Corticosteroids are the mainstay of treatment for minimal change nephrotic syndrome due to their immunosuppressive effects, which help reduce proteinuria and control the disease progression. Antihypertensive agents are not the primary treatment for this condition and are typically used to manage hypertension that may result from nephrotic syndrome. Long-term diuretics are not indicated in the treatment of minimal change nephrotic syndrome as they do not address the underlying cause. Increasing fluids to promote diuresis is not a recommended treatment for minimal change nephrotic syndrome, as it can exacerbate edema and fluid overload in these patients.

2. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?

• A. Acidosis
• B. Alkalosis
• C. Hyperkalemia
• D. Hypernatremia

Correct answer: B

Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.

3. A school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?

• A. Varicella (Chickenpox)
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.

4. A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?

• A. Feeding problems are common in neonates.
• B. Inadequate sucking is not significant unless cyanosis is present.
• C. Ineffective sucking and swallowing may be early indications of a heart defect.
• D. Many neonates retain mucus, which can interfere with feeding for several weeks.

Correct answer: C

Rationale: Ineffective sucking and swallowing can be early signs of a heart defect like a ventricular septal defect. This is crucial information for the nurse to consider as it aligns with the infant's tentative diagnosis. Choice A is too general and does not provide specific relevance to the situation. Choice B is incorrect as inadequate sucking can indeed be significant, especially in the context of a potential heart defect. Choice D is not directly related to the potential heart defect and feeding difficulties mentioned in the scenario.

5. A child with a diagnosis of diabetes insipidus is admitted to the hospital. What is the priority nursing intervention?

• A. Administering insulin
• B. Monitoring fluid balance
• C. Administering diuretics
• D. Monitoring vital signs

Correct answer: B

Rationale: The correct answer is monitoring fluid balance. In a child with diabetes insipidus, the primary concern is excessive urination and fluid loss, which can lead to dehydration. Monitoring fluid balance is crucial to prevent dehydration and maintain electrolyte balance. Administering insulin (Choice A) is not indicated in diabetes insipidus, as this condition is not related to insulin deficiency. Administering diuretics (Choice C) should be avoided as it can exacerbate fluid loss in a child already at risk for dehydration. While monitoring vital signs (Choice D) is important, the priority intervention in this situation is monitoring fluid balance to prevent complications associated with dehydration.

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