Nursing Elites

1. A healthcare provider is assessing a 2-year-old child with suspected Down syndrome. What characteristic physical feature is the healthcare provider likely to observe?

• A. Epicanthal folds
• B. Webbed neck
• C. Enlarged head
• D. Polydactyly

Correct answer: A

Rationale: Epicanthal folds are a common physical feature seen in individuals with Down syndrome. These are folds of skin that cover the inner corners of the eyes. Webbed neck (Choice B) is associated with Turner syndrome, not Down syndrome. Enlarged head (Choice C) is not a typical physical characteristic of Down syndrome. Polydactyly (Choice D) is the presence of extra fingers or toes, which is not specifically related to Down syndrome.

2. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.

3. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.

4. A nurse is assessing a child with suspected rotavirus infection. What clinical manifestation is the nurse likely to observe?

• A. Abdominal pain
• B. Diarrhea
• C. Constipation
• D. Vomiting

Correct answer: B

Rationale: The correct answer is B: Diarrhea. Rotavirus infection commonly presents with symptoms such as watery diarrhea, vomiting, fever, and abdominal pain. While abdominal pain and vomiting are also associated with rotavirus infection, diarrhea is a hallmark feature. Constipation is not typically seen in cases of rotavirus infection. Therefore, the most likely clinical manifestation that the nurse would observe in a child with suspected rotavirus infection is diarrhea.

5. A 3-year-old child with a history of frequent respiratory infections is being evaluated for cystic fibrosis. What diagnostic test should the nurse anticipate will be ordered?

• A. Chest X-ray
• B. Sweat chloride test
• C. Pulmonary function test
• D. Sputum culture

Correct answer: B

Rationale: The sweat chloride test is the gold standard diagnostic test for cystic fibrosis as it measures the concentration of chloride in sweat. In cystic fibrosis, there is an abnormal transport of chloride across epithelial membranes, leading to elevated sweat chloride levels. A chest X-ray may show characteristic changes in the lungs associated with cystic fibrosis, but it is not a definitive diagnostic test. Pulmonary function tests assess lung function but do not specifically diagnose cystic fibrosis. Sputum culture may identify respiratory infections but does not confirm the diagnosis of cystic fibrosis.

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