Nursing Elites

1. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?

• A. Acute diarrhea and dehydration
• B. Current jelly-like stools and pain
• C. Failure to pass meconium and abdominal distension
• D. Projectile vomiting and altered electrolytes

Correct answer: C

Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.

2. What clinical manifestation should be the most suggestive of acute appendicitis?

• A. Rebound tenderness
• B. Bright red or dark red rectal bleeding
• C. Abdominal pain that is relieved by eating
• D. Colicky, cramping abdominal pain around the umbilicus

Correct answer: D

Rationale: The correct answer is D: Colicky, cramping abdominal pain around the umbilicus. This type of pain is a common early sign of acute appendicitis. Rebound tenderness, choice A, is a later sign seen in the physical examination of a patient with appendicitis. Rectal bleeding, as described in choice B, is not typically associated with appendicitis. Abdominal pain that is relieved by eating, as mentioned in choice C, is more indicative of peptic ulcer disease rather than appendicitis.

3. A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. How should the nurse respond?

• A. Tell the parents they can stay in the hospital but not on the unit
• B. Read the rules and regulations of rooming in with the child
• C. Let the parents know they are allowed to stay with the child
• D. Explain to the parents why they cannot stay with the child

Correct answer: C

Rationale: The correct response is to let the parents know they are allowed to stay with the child. Allowing parents to stay with the child can help reduce the child's anxiety and provide comfort. Choice A is incorrect as the parents should be encouraged to stay with their child. Choice B is not the immediate response the nurse should provide. Choice D is inappropriate as it does not address the benefits and importance of parental presence for the child's well-being during hospitalization.

4. A parent and 4-year-old child are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the child doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?

• A. Reading a book
• B. Singing a song he learned at preschool
• C. Opening drawers in the room, pulling out supplies, and examining them
• D. Roughhousing with the parent

Correct answer: C

Rationale: The correct answer is C. According to Erikson, the primary task of a preschool-aged child is to explore and assert control over their environment. This behavior is demonstrated by the child opening drawers, pulling out supplies, and examining them, showcasing curiosity and exploration. Choices A, B, and D do not align with the primary developmental task of a preschool-age child according to Erikson. Reading a book and singing a song are more passive activities, while roughhousing with the parent does not directly relate to exploration and asserting control over the environment.

5. What is a classic sign of congenital hypothyroidism in newborns?

• A. Jaundice
• B. Hypothermia
• C. Prolonged jaundice
• D. Excessive crying

Correct answer: C

Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.

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