Nursing Elites

1. Why is it recommended that closure of the palate should be done before the age of 2 for an 11-month-old infant with a cleft palate?

• A. “After the age of 2, surgery becomes frightening and should be avoided if possible.”
• B. “The eruption of the 2-year molars often complicates the surgical procedure.”
• C. “As your child grows older, the palate widens, making repair more challenging.”
• D. “Surgery should be performed before your child begins to use faulty speech patterns.”

Correct answer: D

Rationale: It is recommended to perform palate closure surgery before the child starts using faulty speech patterns to prevent the development of speech issues that may be harder to correct later. Delaying surgery until after the age of 2 can lead to the child forming incorrect speech habits, which can be challenging to correct. Choices A, B, and C are incorrect because they do not address the specific concern related to speech development in children with cleft palates.

2. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

3. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

4. The nurse is teaching a parent group about the reasons for adhering to the immunization schedule. What complication of mumps is important for adolescents to avoid?

• A. Sterility
• B. Hypopituitarism
• C. Decrease in libido
• D. Decrease in androgens

Correct answer: A

Rationale: The correct answer is A: Sterility. Mumps can lead to serious complications such as sterility, especially in adolescent males. Vaccination is essential to prevent this potential outcome. Hypopituitarism (Choice B) is not a typical complication of mumps. Choices C and D, decrease in libido and decrease in androgens, are not directly associated with mumps complications, particularly in the context of adolescents.

5. .The parents of a 6-week-old infant who was born without an immune system ask a nurse why their baby is still so healthy. How should the nurse reply?

• A. Exposure to pathogens during this time can be limited.
• B. Some antibodies are produced by the infant’s colonic bacteria.
• C. Antibodies are passively received from the mother through the placenta and breast milk.
• D. Fewer antibodies are produced by the fetal thymus during the eighth and ninth months of gestation.

Correct answer: C

Rationale: Infants receive passive immunity through antibodies from the mother during pregnancy and breastfeeding, which protect them initially.

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