Nursing Elites

1. Parents would suspect hearing loss if their child did not:

• A. Turn away from a sound
• B. Startle with sudden loud noises immediately after birth
• C. Talk at 4 months
• D. Babble at 2 months

Correct answer: D

Rationale: The correct answer is D because babbling is an early indicator of hearing ability in infants. Lack of babbling by 2 months may suggest a potential hearing issue. Choices A, B, and C are incorrect because turning away from a sound, startling with sudden loud noises immediately after birth, and talking at 4 months are not primary indicators of hearing loss in infants.

2. What is the most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants?

• A. Gastroesophageal reflux
• B. Respiratory distress
• C. Stricture formation
• D. Aspiration pneumonia

Correct answer: C

Rationale: The most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants is stricture formation. This complication occurs due to the healing process after surgery, leading to the narrowing of the esophagus. Gastroesophageal reflux (Choice A) can be a concern but is not the most common complication. Respiratory distress (Choice B) may happen but is not the primary complication. Aspiration pneumonia (Choice D) is a risk but is typically not as common as stricture formation in these cases.

3. A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

• A. Careful bathing and handling
• B. Monitoring of behavioral status
• C. Maintenance of strict isolation
• D. Administration of packed red blood cells

Correct answer: A

Rationale: The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.

4. What major complication is associated with a child with chronic renal failure?

• A. Hypokalemia
• B. Metabolic alkalosis
• C. Water and sodium retention
• D. Excessive excretion of blood urea nitrogen

Correct answer: C

Rationale: Water and sodium retention is a major complication in chronic renal failure, leading to hypertension and edema. Hypokalemia and metabolic alkalosis are less common, and while BUN levels rise, retention rather than excretion is problematic in chronic renal failure.

5. Which pediatric condition is characterized by a "string sign" on an upper GI series?

• A. Intussusception
• B. Hypertrophic pyloric stenosis
• C. Hirschsprung disease
• D. Meckel diverticulum

Correct answer: B

Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.

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