Nursing Elites

1. The healthcare professional is assessing a 4-year-old client. Which finding suggests to the healthcare professional this child may have a genetic disorder?

• A. Inquiry reveals the child had feeding problems.
• B. The child weighs 40 lb (18.2 kg) and is 40 in (101.6 cm) in height.
• C. The child has low-set ears with lobe creases.
• D. The child can hop on one foot but cannot skip.

Correct answer: C

Rationale: Low-set ears with lobe creases are often associated with genetic disorders and can indicate underlying chromosomal abnormalities. This physical characteristic is known to be a common sign in various syndromes like Down syndrome. Choices A, B, and D are not directly linked to genetic disorders. Feeding problems and specific weight/height measurements are more general indicators of growth and development, while the ability to hop on one foot but not skip is a developmental milestone assessment that does not specifically point towards a genetic disorder.

2. When teaching an adolescent with type 1 diabetes about dietary management, what should the nurse include?

• A. Eating meals at home is recommended.
• B. Food portions should be measured using a gram scale.
• C. Ensure a ready source of glucose is available.
• D. No specific foods need to be cooked for the adolescent.

Correct answer: C

Rationale: When teaching an adolescent with type 1 diabetes about dietary management, it is crucial to ensure a ready source of glucose is available. In cases of hypoglycemia, having a quick source of glucose can help raise blood sugar levels rapidly. Option A is not the most critical aspect of dietary management for an adolescent with type 1 diabetes. While it is generally recommended to eat meals at home for better control over food choices, the availability of a ready glucose source takes precedence. Option B, weighing foods on a gram scale, may not be practical for every meal and could be burdensome. Option D, cooking specific foods for the adolescent, is not necessary as the focus should be on the overall dietary plan rather than individualized meals.

3. What is one of the most important factors that a healthcare professional must consider when parents of a toddler request to be present at a procedure occurring on the hospital unit?

• A. Type of procedure to be performed
• B. Individual assessment of the parents
• C. Whether the toddler wants the parents present
• D. Probable reaction to the toddler’s response to pain

Correct answer: B

Rationale: When parents of a toddler request to be present during a procedure, it is crucial to conduct an individual assessment of the parents. This assessment helps healthcare professionals understand the parents' ability to cope with the procedure, provide support to their child, and ensure a safe and comfortable environment for all involved. Choice A, the type of procedure to be performed, while important, is not the most critical factor in this scenario. Choice C, whether the toddler wants the parents present, is significant but secondary to assessing the parents themselves. Choice D, probable reaction to the toddler’s response to pain, is important but focuses more on the child's reaction rather than the parents' capacity to provide appropriate support.

4. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: Tetralogy of Fallot is characterized by a combination of four specific cardiac defects: right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of tetralogy of Fallot. Choice B describes transposition of the great arteries rather than tetralogy of Fallot. Choice D includes an atrial septal defect, which is not part of the classic presentation of tetralogy of Fallot.

5. A child with a cardiac malformation associated with left-to-right shunting. What does this type of congenital disorder lead to primarily?

• A. Elevated hematocrit
• B. Severe growth retardation
• C. Clubbing of the fingers and toes
• D. Increased blood flow to the lungs

Correct answer: D

Rationale: Left-to-right shunting in a cardiac malformation results in increased blood flow to the lungs. This increased blood flow can lead to pulmonary hypertension and heart failure if left untreated. Elevated hematocrit (Choice A) is not a characteristic directly associated with left-to-right shunting. Severe growth retardation (Choice B) is not a typical manifestation of this type of congenital disorder. Clubbing of the fingers and toes (Choice C) is more commonly seen in conditions like chronic respiratory or cardiac diseases, not specifically with left-to-right shunting and associated cardiac malformations.

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