Nursing Elites

1. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?

• A. Gastrointestinal perforation may have occurred.
• B. The object may have been aspirated.
• C. The object may be lodged in the esophagus.
• D. The object may be embedded in the stomach wall.

Correct answer: C

Rationale: The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.

2. What statement is most descriptive of Meckel diverticulum?

• A. It is present from birth.
• B. Intestinal bleeding may be mild or profuse.
• C. It occurs with equal frequency in both genders.
• D. Surgical interventions are always necessary to treat the problem.

Correct answer: B

Rationale: The correct answer is B. Meckel diverticulum often presents with intestinal bleeding, which can vary in severity. It is a congenital condition, meaning it is present from birth, not acquired during childhood (choice A). Meckel diverticulum is slightly more common in males than in females, so it does not occur more frequently in females (choice C). While some cases of Meckel diverticulum may require surgical intervention, medical interventions can also be sufficient to treat the problem, so it is not always necessary to resort to surgery (choice D).

3. What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

• A. Low specific gravity
• B. Decreased hemoglobin
• C. Normal platelet count
• D. Reduced serum albumin

Correct answer: D

Rationale: Reduced serum albumin is a hallmark of minimal change nephrotic syndrome (MCNS) due to massive proteinuria. This results in hypoalbuminemia, which contributes to the edema characteristic of this condition.

4. What is the most common symptom of gastroesophageal reflux in infants?

• A. Projectile vomiting
• B. Bilious vomiting
• C. Frequent spitting up
• D. Diarrhea

Correct answer: C

Rationale: Frequent spitting up is indeed a common symptom of gastroesophageal reflux in infants. It is caused by the backward flow of stomach contents into the esophagus, leading to infants regurgitating milk or formula shortly after feeding. Projectile vomiting (choice A) is more commonly associated with conditions like pyloric stenosis rather than gastroesophageal reflux. Bilious vomiting (choice B) often indicates an obstruction in the gastrointestinal tract. Diarrhea (choice D) is not typically a primary symptom of gastroesophageal reflux in infants.

5. The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?

• A. We will wash our hands often, especially after diaper changes
• B. We know that roundworm can be transmitted from person to person
• C. We will be sure to continue the nitazoxanide (Alinia) orally for 3 days
• D. We will bring a stool sample to the clinic for examination in 2 weeks

Correct answer: B

Rationale: Roundworm (ascariasis) is typically transmitted through ingestion of contaminated soil, not directly from person to person. This statement indicates a misunderstanding requiring clarification.

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