Nursing Elites

1. The nurse is caring for a child with Beta Thalassemia. Which child is in a group most at risk for Beta Thalassemia?

• A. A three-year-old girl of Mediterranean descent.
• B. A ten-year-old boy of Hispanic descent.
• C. A young girl of African descent.
• D. A baby of European descent.

Correct answer: A

Rationale: Corrected Rationale: Beta Thalassemia is most common in individuals of Mediterranean descent, such as those from Italy, Greece, and the Middle East. This genetic disorder affects hemoglobin production and can lead to severe anemia. Choice A is the correct answer as individuals of Mediterranean descent are at the highest risk for Beta Thalassemia. Choices B, C, and D are incorrect as they do not belong to the population group most at risk for this genetic disorder.

2. What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?

• A. Hold feedings.
• B. Check gastric residuals before feedings.
• C. Take rectal temperature.
• D. Closely monitor abdominal distention.

Correct answer: D

Rationale: The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.

3. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?

• A. Identity vs. role diffusion
• B. Trust vs. mistrust
• C. Industry vs. inferiority
• D. Autonomy vs. shame and doubt

Correct answer: A

Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.

4. Which disease would require strict isolation of the patient?

• A. Mumps
• B. Chickenpox
• C. Exanthema subitum (roseola)
• D. Erythema infectiosum (fifth disease)

Correct answer: B

Rationale: The correct answer is B: Chickenpox. Chickenpox is highly infectious and is transmitted through direct contact, droplet spread, and contaminated objects. Due to its high communicability, strict isolation of the patient is necessary to prevent the spread of the disease. Mumps is primarily transmitted through direct contact with the infected person's saliva, with peak contagiousness before the onset of swelling. Exanthema subitum (roseola) has an unknown transmission source. Erythema infectiosum (fifth disease) is contagious before the appearance of symptoms. Therefore, these diseases do not require the same level of strict isolation as chickenpox.

5. What findings on physical assessment of a neonate would indicate the need for further evaluation?

• A. Nystagmus
• B. Epstein pearls
• C. Low-set ears
• D. Positive Babinski reflex

Correct answer: C

Rationale: Low-set ears in a neonate suggest major abnormalities and should prompt further evaluation. The correct alignment of the top of the pinnae of the ear with the outer canthus of the eye is crucial. Nystagmus, an involuntary eye movement, is common in newborns and often resolves on its own. Epstein pearls, small cysts on the hard palate, are insignificant and disappear over time. A positive Babinski reflex is normal in infants up to 1 year of age. Therefore, the presence of low-set ears is the most concerning finding that requires immediate attention.

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