Nursing Elites

1. An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of defective utilization. The nurse understands that the reason for the FTT is most likely related to what?

• A. Cystic fibrosis
• B. Hyperthyroidism
• C. Congenital infection
• D. Breastfeeding problems

Correct answer: C

Rationale: FTT classified as defective utilization is often related to conditions like congenital infections, which interfere with the body's ability to effectively use nutrients. Conditions like cystic fibrosis and hyperthyroidism can also contribute to FTT but are categorized differently

2. The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

• A. Consuming a regular diet
• B. Increasing protein
• C. Restricting fluids
• D. Decreasing calories

Correct answer: C

Rationale: Fluid restriction is often necessary to manage severe edema associated with MCNS. Increasing protein is not typically recommended due to the risk of exacerbating proteinuria, and calorie reduction is not generally needed.

3. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?

• A. Restlessness
• B. Distractibility
• C. Rectal discharge
• D. Intense perianal itching

Correct answer: D

Rationale: Intense perianal itching is the most common symptom of pinworm infection, especially at night when the female worms lay their eggs

4. A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

• A. Prominent abdomen
• B. Forward curve of the spine in the sacral area
• C. Increase in height of 5 inches in the past year
• D. Total weight gain of 15 lb in the past year

Correct answer: D

Rationale: The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.

5. Which congenital heart defect causes a "boot-shaped" heart on a chest x-ray?

• A. Tetralogy of Fallot
• B. Coarctation of the aorta
• C. Transposition of the great arteries
• D. Ventricular septal defect

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot, a congenital heart defect with four distinct abnormalities, often presents with a "boot-shaped" heart on chest x-ray due to right ventricular hypertrophy. This characteristic finding is due to the specific combination of defects in this condition. Coarctation of the aorta (choice B), Transposition of the great arteries (choice C), and Ventricular septal defect (choice D) do not typically result in a "boot-shaped" heart on a chest x-ray like Tetralogy of Fallot does.

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