Nursing Elites

1. During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?

• A. Abnormal and requires further investigation
• B. Abnormal unless it occurs in conjunction with knock-knee
• C. Normal if the condition is unilateral or asymmetric
• D. Normal because the lower back and leg muscles are not yet well developed

Correct answer: D

Rationale: Bowleggedness is normal in toddlers due to the development of lower back and leg muscles. It usually resolves as the child grows.

2. Which condition is most commonly associated with a 'sunset sign' in infants?

• A. Hydrocephalus
• B. Meningitis
• C. Cerebral palsy
• D. Encephalitis

Correct answer: A

Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'

3. What is a physical characteristic of infants whose mothers smoked during pregnancy?

• A. Being large for gestational age
• B. Growth restriction in weight only
• C. Preterm but size appropriate for gestational age
• D. Growth restriction in weight, length, and chest and head circumference

Correct answer: D

Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.

4. The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

• A. Place a warm moist pack on the scrotal area.
• B. Instruct the adolescent to lie down and elevate the legs.
• C. Refer the adolescent for immediate medical evaluation.
• D. Suggest that the adolescent wear a scrotum-protecting guard.

Correct answer: C

Rationale: Testicular torsion is a surgical emergency requiring immediate medical evaluation. Applying heat or elevating the legs will not alleviate the torsion, and delaying care can lead to testicular necrosis.

5. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)

• A. Fluoridated water should be used.
• B. Early childhood caries is a preventable disease
• C. All options are correct
• D. Dental hygiene should begin with the first tooth eruption

Correct answer: C

Rationale: Fluoridated water helps prevent caries, early childhood caries is preventable, and dental hygiene should start with the first tooth eruption.

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