Nursing Elites

1. Which type of play is most appropriate for a hospitalized toddler?

• A. Cooperative play
• B. Parallel play
• C. Competitive play
• D. Solitary play

Correct answer: B

Rationale: The most appropriate type of play for a hospitalized toddler is parallel play. This type of play allows toddlers to engage alongside each other but not directly with each other, which can be comforting and less overwhelming in a hospital setting. Cooperative play (choice A) involves working together towards a common goal, which may be challenging for a hospitalized toddler. Competitive play (choice C) involves a level of rivalry that may not be suitable during a hospital stay. Solitary play (choice D) involves playing alone, which may not provide the social interaction and distraction that parallel play can offer in a hospital environment.

2. What is a physical characteristic of infants whose mothers smoked during pregnancy?

• A. Being large for gestational age
• B. Growth restriction in weight only
• C. Preterm but size appropriate for gestational age
• D. Growth restriction in weight, length, and chest and head circumference

Correct answer: D

Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.

3. The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?

• A. My child needs to stay home from school for at least 1 more month.
• B. I should not add additional salt to any of my child's meals.
• C. My child will not be able to participate in contact sports while receiving corticosteroid therapy.
• D. I should measure my child's urine after each void and report the 24-hour amount to the healthcare provider.

Correct answer: B

Rationale: Avoiding additional salt is crucial to help manage edema in children with MCNS. While monitoring urine output is important, the other statements either misinterpret the need for prolonged school absence or misunderstand the risk associated with contact sports during steroid therapy.

4. The parent of a 3-month-old infant is concerned because the infant is not able to sit independently. How should the nurse respond to this parent's concern?

• A. Sitting ability and the age of first tooth eruption are not correlated.
• B. Most infants sit steadily at 4 months.
• C. Most infants sit steadily at 3 months.
• D. Most infants do not sit steadily until 6-8 months.

Correct answer: D

Rationale: The correct answer is D because sitting steadily typically occurs closer to 6-8 months of age, not 3 or 4 months. Choice A is incorrect because sitting ability and the age of first tooth eruption are not related. Choice B and C are incorrect as most infants do not sit steadily at 3 or 4 months, and it is more common for infants to achieve this milestone around 6-8 months.

5. The parents of a child with acute postinfectious glomerulonephritis (APIGN) ask how they will know that the condition is improving. How should the nurse respond?

• A. Your child’s urine output will increase, and the urine will become less brown in color.
• B. Your child will rest more comfortably.
• C. Your child’s appetite will decrease.
• D. Your child’s laboratory test values will show increased BUN.

Correct answer: A

Rationale: Improvement in APIGN is indicated by an increase in urine output and a change in urine color from brown (due to hematuria) to a more normal appearance. This reflects a reduction in glomerular inflammation and improved kidney function. Choice B is incorrect because resting more comfortably is not a direct indicator of kidney function improvement. Choice C is incorrect because a decrease in appetite is not typically associated with improvement in APIGN. Choice D is incorrect because an increased BUN value would suggest worsening kidney function rather than improvement.

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