Nursing Elites

1. Physiological anorexia in toddlerhood occurs because of:

• A. Decreased appetite and decreased nutritional need
• B. Decreased appetite and increased nutritional need
• C. Increased appetite and lack of food preferences
• D. Increased appetite and strong food preferences

Correct answer: A

Rationale: Physiological anorexia in toddlers occurs due to a decreased appetite as growth rates slow down. Choice A is correct because it aligns with the concept that toddlers experience a natural decrease in appetite as their growth rate decreases. Choices B, C, and D are incorrect because they suggest increased appetite or other factors not associated with physiological anorexia in toddlerhood.

2. Picking up a pencil demonstrates the ability to use which of the following?

• A. Pincer grasp
• B. Prehension
• C. Parachute reflex
• D. Grasp reflex

Correct answer: A

Rationale: Picking up a pencil requires the use of the pincer grasp, which involves the coordination of the thumb and forefinger to hold small objects. The pincer grasp is a fine motor skill essential for tasks that necessitate precision and dexterity. Choices B, C, and D are incorrect. Prehension refers to the act of grasping or holding an object, parachute reflex is a protective response to sudden movement or loss of support, and grasp reflex is an automatic closing of the hand when an object is placed in the palm, none of which specifically relate to the action of picking up a pencil.

3. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?

• A. "We should watch for aggressive play."
• B. "Our child may show lasting symptoms of stress."
• C. "We know that our child will show caring behaviors."
• D. "Our child may have difficulty concentrating in school."

Correct answer: C

Rationale: Children exposed to chronic violence may struggle with stress and concentration but are less likely to consistently exhibit caring behaviors without intervention and support.

4. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?

• A. Hyperkalemia
• B. Hyperchloremia
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: D

Rationale: Excessive vomiting in pyloric stenosis leads to the loss of stomach acid (hydrochloric acid), resulting in metabolic alkalosis, not hyperkalemia, hyperchloremia, or metabolic acidosis. Metabolic alkalosis is characterized by a higher pH level in the blood due to the loss of acid and a relative increase in bicarbonate. Hyperkalemia is an elevated level of potassium in the blood and is not directly related to excessive vomiting in pyloric stenosis. Hyperchloremia is an excess of chloride in the blood, which is not typically associated with this condition. Metabolic acidosis is a condition characterized by a lower pH level in the blood, caused by an excess of acid or a loss of bicarbonate, which is not the typical complication seen in pyloric stenosis with excessive vomiting.

5. The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include?

• A. Keep the tube clamped.
• B. Suction the tube as needed.
• C. Leave the tube open to gravity drainage.
• D. Secure the tube with tape.

Correct answer: C

Rationale: Leaving the gastrostomy tube open to gravity drainage prevents the accumulation of air and fluids, reducing the risk of complications such as vomiting or aspiration in the immediate postoperative period. Keeping the tube clamped or suctioning it can lead to pressure buildup, increasing the risk of complications. Securing the tube with tape is important but not the primary action related to the gastrostomy tube in this case.

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