Nursing Elites

1. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?

• A. An emergency laparotomy is very likely.
• B. The location needs to be confirmed by radiographic examination.
• C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
• D. Careful observation is essential because an ingested battery cannot be accurately detected.

Correct answer: B

Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.

2. The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?

• A. Citrus
• B. All of the above
• C. Spicy foods
• D. Peppermint

Correct answer: B

Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.

3. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

• A. Seizure disorder
• B. Narcotic withdrawal
• C. Placental insufficiency
• D. Meconium aspiration syndrome

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

4. What is a suitable nutritional goal for a preschool-aged child?

• A. Minimize messiness and spills.
• B. Introduce new foods gradually and provide variety.
• C. Finish all the food on the plate.
• D. Allow the child to eat only preferred foods.

Correct answer: B

Rationale: Introducing new foods gradually and offering a variety of options is a suitable nutritional goal for preschool-aged children as it helps in providing essential nutrients and expanding their palate. Choice A is incorrect as reducing messiness and spills is more related to behavior than nutrition. Choice C is incorrect as forcing a child to finish all the food on the plate may override their natural hunger and fullness cues. Choice D is incorrect as allowing a child to eat only preferred foods may lead to an imbalanced diet lacking in essential nutrients.

5. Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?

• A. Medical therapy is not effective after this age.
• B. Treatment is necessary to maintain the ability to be fertile when older.
• C. The younger child can tolerate the extensive surgery needed.
• D. Sexual reassignment may be necessary if treatment is not successful.

Correct answer: B

Rationale: Early treatment of cryptorchidism is essential to preserve fertility and prevent complications such as testicular cancer. Surgery is usually well-tolerated, and sexual reassignment is not typically related to this condition.

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