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. Which pediatric condition is most likely to present with a "whooping" sound during coughing?

• A. Croup
• B. Bronchitis
• C. Pertussis
• D. Asthma

Correct answer: C

Rationale: The correct answer is C: Pertussis. Pertussis, also known as whooping cough, is characterized by a "whooping" sound during coughing episodes. This distinctive sound is due to the rapid intake of air after a series of coughs. Choice A, Croup, typically presents with a barking cough and stridor. Choice B, Bronchitis, is characterized by a productive cough with mucus. Choice D, Asthma, usually presents with wheezing and shortness of breath.

3. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?

• A. On the lower jaw
• B. Side of the tongue
• C. Against the soft palate
• D. Center back area of the tongue

Correct answer: B

Rationale: The side of the tongue is the appropriate place for a tongue blade to avoid triggering the gag reflex during assessment of the mouth and throat.

4. What is the most effective method to prevent infection in the newborn?

• A. Using disposable items
• B. Practicing proper hand hygiene by staff and family
• C. Administering prophylactic antibiotics
• D. Isolating the newborn from others

Correct answer: B

Rationale: The most effective method to prevent infection in newborns is by practicing proper hand hygiene by staff and family. This is crucial as it helps reduce the transmission of infectious agents, protecting vulnerable newborns. Using disposable items may help, but proper hand hygiene is more effective. Administering prophylactic antibiotics without a specific indication can lead to antibiotic resistance and is not recommended. Isolating the newborn from others is not practical and may not be necessary if proper hand hygiene is maintained.

5. According to Erikson’s theory of psychosocial development, the school-age child is in which stage?

• A. Industry vs. inferiority
• B. Autonomy vs. shame and doubt
• C. Identity vs. role diffusion
• D. Trust vs. mistrust

Correct answer: A

Rationale: The correct answer is A: 'Industry vs. inferiority.' According to Erikson’s theory, school-age children (approximately 6-12 years old) are in the stage of industry vs. inferiority. In this stage, children focus on developing a sense of competence and productivity. Choice B, 'Autonomy vs. shame and doubt,' is incorrect as it refers to the stage that occurs during early childhood (1-3 years old). Choice C, 'Identity vs. role diffusion,' pertains to adolescence (12-18 years old). Choice D, 'Trust vs. mistrust,' is related to the stage of infancy (0-1 year old). Therefore, option A is the most appropriate stage for school-age children in Erikson's theory.

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