Nursing Elites

1. A healthcare provider is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the healthcare provider likely to observe?

• A. Projectile vomiting
• B. Diarrhea
• C. Constipation
• D. Abdominal distension

Correct answer: A

Rationale: Projectile vomiting is a classic clinical manifestation of pyloric stenosis in infants. This occurs due to the narrowing of the pyloric sphincter, leading to the forceful expulsion of gastric contents in a projectile manner. Diarrhea (choice B) is not typically associated with pyloric stenosis. Constipation (choice C) is also not a common symptom of this condition. Abdominal distension (choice D) may occur in pyloric stenosis but is not as specific or characteristic as projectile vomiting in diagnosing this condition.

2. During a clinical conference with a group of nursing students, the instructor is describing burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?

• A. Skin that is reddened, dry, and slightly swollen
• B. Skin appearing wet with significant pain
• C. Skin with blistering and swelling
• D. Skin that is leathery and dry with some numbness

Correct answer: D

Rationale: Full-thickness burns are characterized by a leathery, dry appearance with numbness due to nerve damage. Choice A describes characteristics of superficial burns, which are not full-thickness. Choice B describes characteristics of partial-thickness burns with intact blisters, not full-thickness burns. Choice C describes characteristics of partial-thickness burns with blistering and swelling, not full-thickness burns.

3. What factor predisposes the urinary tract to infection in children?

• A. increased fluid intake
• B. short urethra in young girls
• C. prostatic secretions in males
• D. frequent emptying of the bladder

Correct answer: B

Rationale: The short urethra in young girls is a significant factor that predisposes them to urinary tract infections. Girls have a shorter urethra than boys, making it easier for bacteria to travel up the urinary tract, leading to infections. Increased fluid intake (Choice A) is actually a preventive measure as it helps flush out bacteria from the urinary tract. Prostatic secretions in males (Choice C) do not predispose the urinary tract to infection in children. Frequent emptying of the bladder (Choice D) is also a good practice to prevent urinary tract infections by reducing the chances of bacterial growth in the urinary tract.

4. A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the nurse expect?

• A. Proteinuria
• B. Peripheral edema
• C. Elevated hematocrit
• D. Absence of pedal pulses

Correct answer: C

Rationale: In a child with a congenital cardiac malformation causing right-to-left shunting of blood, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not a typical clinical finding related to right-to-left shunting. Peripheral edema (Choice B) is more commonly associated with conditions causing volume overload, such as left-sided heart failure. Absence of pedal pulses (Choice D) is not directly related to right-to-left shunting but may be seen in conditions affecting peripheral circulation.

5. A child has been diagnosed with classic hemophilia. A nurse teaches the child’s parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?

• A. Whenever a bleed is suspected
• B. In the morning on scheduled days
• C. At bedtime while the child is lying quietly in bed
• D. On a regular schedule at the parents’ convenience

Correct answer: B

Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.

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