Nursing Elites

1. The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?

• A. Most childhood cancers affect tissues rather than organs.
• B. Childhood cancers are usually localized when found.
• C. Unlike adult cancers, childhood cancers are less responsive to treatment.
• D. The majority of childhood cancers can be prevented.

Correct answer: A

Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers may not always be localized when found. Choice C is incorrect as childhood cancers can be responsive to treatment, although treatment approaches may differ from adult cancers. Choice D is incorrect as the majority of childhood cancers cannot be prevented; however, certain risk factors can be managed to reduce the risk of developing cancer.

2. What definitive diagnostic procedure does the nurse expect to be used to confirm the diagnosis of Hirschsprung disease in a 1-month-old infant?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. This procedure reveals the absence of ganglion cells in the affected bowel segment, which is a hallmark of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for diagnosing Hirschsprung disease due to the risk of not accurately reaching the affected segment. Multiple saline enemas (Choice C) are not used to confirm the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a standard diagnostic procedure for Hirschsprung disease and does not provide the necessary information to confirm the absence of ganglion cells in the affected bowel segment.

3. An 18-month-old was brought to the emergency department by her mother, who states, 'I think she broke her arm.' The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

• A. Plastic deformity
• B. Buckle fracture
• C. Spiral fracture
• D. Greenstick fracture

Correct answer: C

Rationale: A spiral fracture is a type of fracture often associated with twisting injuries and can raise suspicion of child abuse. This type of fracture is caused by a twisting force applied to a bone. Plastic deformity is not typically associated with fractures but refers to the ability of a material to change shape and retain that shape. A buckle fracture, also known as a torus fracture, is an incomplete break in a bone commonly seen in children. A greenstick fracture is an incomplete fracture where the bone is bent and partially broken, more commonly seen in children due to their bone flexibility.

4. A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?

• A. Cannot stand on one foot
• B. Builds a tower of 7 blocks
• C. Uses echolalia when speaking
• D. Colors outside the lines of a picture

Correct answer: C

Rationale: The correct answer is C. Using echolalia, which is the repetition of words or phrases, is not typical for a 2-year-old child and may indicate the need for further evaluation. Choices A, B, and D are all within the expected developmental skills for a 2-year-old. While most 2-year-olds may not be able to stand on one foot, it is not a cause for concern at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both appropriate for a 2-year-old's developmental skills.

5. What is the most common cause of seizures in children?

• A. An abrupt rise in body temperature
• B. An inflammatory process in the brain
• C. A temperature greater than 102°F
• D. A life-threatening infection

Correct answer: C

Rationale: Seizures in children most often result from a temperature greater than 102°F, known as febrile seizures. Febrile seizures are commonly triggered by a rapid increase in body temperature due to infections or other causes. Choice A is incorrect as febrile seizures are not necessarily caused by the abrupt rise in body temperature alone. Choice B is incorrect as inflammatory processes in the brain may lead to other types of seizures but are not the most common cause in children. Choice D is incorrect as not all seizures in children are due to life-threatening infections.

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