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. Children may believe that they are responsible for their parents' divorce and interpret the separation as punishment. At which age is this most likely to occur?

• A. 1 year
• B. 4 years
• C. 8 years
• D. 13 years

Correct answer: C

Rationale: At around 8 years old, children may feel they are responsible for their parents' divorce and view it as a punishment, which can impact their emotional well-being.

3. Which electrolyte imbalance is a common concern in children with severe diarrhea?

• A. Hypernatremia
• B. Hypokalemia
• C. Hypercalcemia
• D. Hypomagnesemia

Correct answer: B

Rationale: Hypokalemia is the correct answer because it is a common concern in children with severe diarrhea. Diarrhea can lead to significant potassium loss, resulting in hypokalemia. Hypernatremia (Choice A) is less common in diarrhea as sodium concentration is usually diluted by the fluid loss. Hypercalcemia (Choice C) is not typically associated with severe diarrhea. Hypomagnesemia (Choice D) can occur but is not as common as hypokalemia in this scenario.

4. What information should the nurse include when teaching an adolescent with Crohn disease (CD)?

• A. How to cope with stress and adjust to chronic illness
• B. Preparation for surgical treatment and cure of CD
• C. Nutritional guidance and prevention of constipation
• D. Prevention of spread of illness to others and principles of high-fiber diet

Correct answer: A

Rationale: Teaching about coping with stress and adjusting to chronic illness is crucial for adolescents with Crohn disease. CD is a chronic condition with no cure, so focusing on managing the disease, stress, and diet is essential for improving the adolescent's quality of life. Choice B is incorrect because Crohn disease cannot be cured surgically. Choice C is relevant but not as essential as coping with stress and chronic illness. Choice D is not a priority in teaching an adolescent with Crohn disease as it mainly focuses on preventing the spread of illness to others, which is not a significant concern with CD, and high-fiber diets may not always be suitable for individuals with this condition.

5. Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play is this?

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

Correct answer: C

Rationale: The correct answer is C, parallel play. Parallel play is observed when children play alongside each other but do not directly interact. In this scenario, each child is engaged in their own activity without engaging or influencing each other's play, which characterizes parallel play. Cooperative play (choice A) involves children playing together towards a common goal, which is not evident in the given situation. Solitary play (choice B) is when a child plays alone, unrelated to the presence of others. Associative play (choice D) involves more interaction and sharing of toys between children, which is not happening in the described play scenario.

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