Nursing Elites

1. The healthcare provider is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

• A. abdominal swelling
• B. weight gain
• C. hypotension
• D. increased urinary output

Correct answer: A

Rationale: Abdominal swelling is a classic presentation and often the first noticeable sign of a Wilms tumor. This occurs due to the tumor mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a presenting symptom compared to abdominal swelling. Hypotension (Choice C) is not typically associated with a Wilms tumor unless complications like bleeding or shock occur. Increased urinary output (Choice D) is not a typical finding for Wilms tumor; instead, patients may present with hematuria or urinary symptoms.

2. What behavior does a toddler subjected to prolonged hospitalization with limited parental visits typically exhibit?

• A. Cheerful interactions with staff members
• B. Indications of sadness throughout the day
• C. Excessive crying when parents are not present
• D. Limited emotional response to the environment

Correct answer: D

Rationale: Toddlers subjected to prolonged hospitalization with limited parental visits often exhibit a limited emotional response to the environment. This behavior is a common coping mechanism in young children facing such situations. While cheerful interactions with staff members (choice A) may occur occasionally, the overall response tends to be subdued. Indications of sadness throughout the day (choice B) and excessive crying when parents are not present (choice C) are less typical in this scenario, as the child may have learned to suppress emotions due to the challenging circumstances.

3. A 4-year-old child is admitted to the hospital with a diagnosis of epiglottitis. What is the priority nursing intervention?

• A. Administer antibiotics
• B. Provide humidified oxygen
• C. Keep the child NPO
• D. Position the child upright

Correct answer: C

Rationale: The priority nursing intervention for a 4-year-old child admitted with epiglottitis is to keep the child NPO (nothing by mouth). This is crucial to prevent further airway compromise due to the inflamed epiglottis. Administering antibiotics may be necessary but is not the priority at this moment. Providing humidified oxygen can support oxygenation but does not address the immediate risk of airway obstruction. Positioning the child upright may help with breathing but does not address the risk of aspiration. Keeping the child NPO is essential to maintain a patent airway and prevent complications associated with epiglottitis.

4. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection?

• A. Burn wound cellulitis.
• B. Invasive burn cellulitis.
• C. Burn impetigo.
• D. Staphylococcal scalded skin syndrome.

Correct answer: B

Rationale: Invasive burn cellulitis is characterized by the burn developing a dark brown, black, or purplish color with discharge and a foul odor. This description aligns with the symptoms observed in the 15-year-old boy. Burn wound cellulitis (Choice A) typically presents with erythema, edema, warmth, and tenderness at the burn site, without the characteristic changes seen in this case. Burn impetigo (Choice C) is a superficial infection characterized by honey-colored crusts, not consistent with the purplish color and foul odor described. Staphylococcal scalded skin syndrome (Choice D) is a condition caused by exotoxins produced by Staphylococcus aureus, leading to widespread desquamation of the skin, but it does not typically present with the specific findings mentioned in the scenario.

5. What finding would lead the nurse to suspect that a child has Turner syndrome?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a key feature seen in Turner syndrome, a genetic condition that occurs in females due to a complete or partial absence of one of the X chromosomes. This physical trait is caused by excess skin on the neck, giving it a webbed appearance. Microcephaly (Choice B) is a condition characterized by a smaller than average head size and is not typically associated with Turner syndrome. Gynecomastia (Choice C) refers to breast enlargement in males and is not a common finding in Turner syndrome, which affects females. Cognitive delay (Choice D) is not a specific characteristic of Turner syndrome, as the syndrome primarily affects physical development and may not necessarily impact cognitive abilities.

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