Nursing Elites

1. What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?

• A. Pyloric stenosis
• B. Intussusception
• C. Hirschsprung disease
• D. Celiac disease

Correct answer: C

Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.

2. The nurse is caring for a child with sickle cell anemia with the following order: Morphine Sulfate 2 mg IV every 24 hours. Morphine Sulfate is available in 10 mg/1mL. How many mL should the nurse administer?

• A. 0.2 mL
• B. 0.5 mL
• C. 1 mL
• D. 2 mL

Correct answer: A

Rationale: To administer 2 mg of Morphine Sulfate when the concentration is 10 mg/mL, the nurse should administer 0.2 mL (2 mg / 10 mg/mL = 0.2 mL). Choice B, 0.5 mL, is incorrect because it is the result of dividing 2 mg by 4 mg/mL instead of 10 mg/mL. Choice C, 1 mL, is incorrect as it would be the result of dividing 2 mg by 2 mg/mL. Choice D, 2 mL, is incorrect as it would be the result of dividing 2 mg by 1 mg/mL.

3. The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?

• A. The infant responds to his own name.
• B. The infant localizes sounds by turning his head directly to the sound.
• C. The infant turns his head to the side when sound is made at the level of the ear.
• D. The infant locates sound by turning his head to the side and then looking up or down.

Correct answer: C

Rationale: By 10 weeks, infants typically turn their heads to the side to locate the source of a sound made at ear level.

4. What is typically the first sign of puberty in females?

• A. Breast development
• B. Menarche
• C. Pubic hair growth
• D. Axillary hair growth

Correct answer: A

Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.

5. According to Piaget, a 6-month-old infant should be in which developmental stage?

• A. Use of reflexes
• B. Primary circular reactions
• C. Secondary circular reactions
• D. Coordination of secondary schemata

Correct answer: C

Rationale: By 6 months, infants are usually in the stage of secondary circular reactions, where they start to intentionally repeat actions that bring pleasure or interesting results.

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