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 parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented?

• A. ''We're glad the dog can continue to sleep in our child’s room.''
• B. ''We’ll keep the plants in our child’s room dusted.''
• C. ''We’ll be sure to use the fireplace often to keep the house warm in the winter.''
• D. ''We will replace the carpet in our child’s bedroom with a hard surface.''

Correct answer: D

Rationale: The correct answer is D. Replacing carpet with hard flooring helps to reduce allergens and asthma triggers in the child’s environment. Choice A is incorrect as having a dog in the child’s room can worsen asthma symptoms due to pet dander. Choice B is incorrect because keeping plants in the child’s room can increase mold spores and allergens. Choice C is incorrect as using a fireplace can introduce smoke and other irritants into the air, worsening asthma symptoms.

3. What is a clinical manifestation of acetaminophen poisoning?

• A. Hyperpyrexia
• B. Hepatic involvement
• C. Severe burning pain in stomach
• D. Drooling and inability to clear secretions

Correct answer: B

Rationale: Acetaminophen poisoning primarily affects the liver, leading to hepatic involvement, which may present as jaundice, liver failure, or elevated liver enzymes. Hyperpyrexia, severe pain, and drooling are more associated with other types of poisoning.

4. Which condition is often associated with a "ground-glass" appearance on a chest x-ray in neonates?

• A. Pneumonia
• B. Respiratory distress syndrome
• C. Bronchopulmonary dysplasia
• D. Congenital diaphragmatic hernia

Correct answer: B

Rationale: The correct answer is B, Respiratory distress syndrome. Respiratory distress syndrome often presents with a "ground-glass" appearance on a chest x-ray in neonates due to surfactant deficiency. Choice A, Pneumonia, typically appears as patchy infiltrates on chest x-ray. Choice C, Bronchopulmonary dysplasia, is characterized by hyperinflation and fibrosis, not a ground-glass appearance. Choice D, Congenital diaphragmatic hernia, usually shows mediastinal shift and bowel loops in the chest cavity on x-ray, not a ground-glass appearance.

5. The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?

• A. Hypertension
• B. Pain at the entry site
• C. Fever and general malaise
• D. Redness and swelling at the entry site

Correct answer: C

Rationale: Fever and general malaise are systemic signs of bacteremia, indicating that the infection may have spread beyond the local entry site. Localized pain, redness, and swelling are signs of a localized infection but do not necessarily indicate bacteremia.

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