Nursing Elites

1. A new mom is instructed to have her toddler brush his teeth every night after dinner. This is an example of __________ which increases the toddler’s sense of security and self-mastery.

• A. Negativism
• B. Diversionary activity
• C. Critical play
• D. Ritualism

Correct answer: D

Rationale: The correct answer is D, Ritualism. Establishing routines like brushing teeth every night after dinner helps toddlers feel secure and in control. Choice A, Negativism, refers to a child's oppositional behavior. Choice B, Diversionary activity, involves redirecting attention to something else. Choice C, Critical play, does not relate to the scenario of establishing a routine for the toddler.

2. Which vaccine is contraindicated in a child with a history of severe egg allergy?

• A. MMR
• B. Varicella
• C. Influenza
• D. Hepatitis B

Correct answer: C

Rationale: The correct answer is C: Influenza. The influenza vaccine is produced using egg-based technology, so individuals with a severe egg allergy are at risk of an allergic reaction if vaccinated with the influenza vaccine. This is due to the potential presence of egg proteins in the vaccine. Choices A, B, and D are not contraindicated in children with severe egg allergy. The MMR and Varicella vaccines do not pose a risk for children with egg allergies, and the Hepatitis B vaccine is also safe for these individuals.

3. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?

• A. Spitting up
• B. Bilious vomiting
• C. Failure to thrive
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.

4. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?

• A. Steatorrhea
• B. Clay-colored
• C. Currant jelly-like
• D. Loose stools with undigested food

Correct answer: C

Rationale: Corrected Rationale: Currant jelly-like stools, which contain blood and mucus, are characteristic of Meckel diverticulum. This symptom occurs due to the bleeding from the ectopic gastric mucosa present in the diverticulum. Steatorrhea (choice A) is not typically associated with Meckel diverticulum. Clay-colored stools (choice B) are seen in conditions affecting the biliary system. Loose stools with undigested food (choice D) may indicate malabsorption issues, but it is not specifically linked to Meckel diverticulum.

5. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

• A. Most boys in the United States can be toilet trained at age 3 years.
• B. Training can begin when he has sufficient bladder capacity.
• C. Additional surgery may be necessary to achieve continence.
• D. They should begin now because he will require additional time.

Correct answer: B

Rationale: Toilet training should begin when the child has sufficient bladder capacity and control, which may be delayed in children who have undergone surgical repairs for conditions like bladder exstrophy. Premature training can lead to frustration and setbacks.

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