Nursing Elites

1. The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurse's intervention include?

• A. Explain the disorder so they can explain it to others.
• B. Help parents understand that this is a minor problem.
• C. Suggest that parents avoid family and friends until the gender is assigned.
• D. Encourage parents not to worry while the tests are being done.

Correct answer: A

Rationale: It is important for the nurse to provide the parents with accurate information so they can confidently explain the situation to others, helping to reduce stress and misinformation. Avoiding family and friends or minimizing the problem is not helpful.

2. The nurse is caring for a 1-month-old infant diagnosed with Hirschsprung’s disease. Which treatment measure should be included in the plan of care?

• A. Barium Enema
• B. Surgical removal of the affected section of bowel
• C. High-fiber diet
• D. Permanent colostomy

Correct answer: B

Rationale: The correct answer is B: Surgical removal of the affected section of bowel. Hirschsprung's disease is a congenital condition where a portion of the large intestine lacks nerve cells, leading to difficulties in passing stool. The definitive treatment for this condition is the surgical removal of the affected section of the bowel. Barium enema (Choice A) may be used for diagnosis but is not a treatment. A high-fiber diet (Choice C) is not effective in managing Hirschsprung's disease. A permanent colostomy (Choice D) is not the initial treatment for this condition in infants.

3. Which vaccine is contraindicated in a child with a history of severe egg allergy?

• A. MMR
• B. Varicella
• C. Influenza
• D. Hepatitis B

Correct answer: C

Rationale: The correct answer is C: Influenza. The influenza vaccine is produced using egg-based technology, so individuals with a severe egg allergy are at risk of an allergic reaction if vaccinated with the influenza vaccine. This is due to the potential presence of egg proteins in the vaccine. Choices A, B, and D are not contraindicated in children with severe egg allergy. The MMR and Varicella vaccines do not pose a risk for children with egg allergies, and the Hepatitis B vaccine is also safe for these individuals.

4. The nurse is caring for an infant after a cleft lip repair. Which of these measures should be included in the plan of care?

• A. Position prone
• B. Provide fluids from a cup
• C. Position supine
• D. Avoid elbow restraints

Correct answer: C

Rationale: The correct measure that should be included in the plan of care for an infant after a cleft lip repair is to position the infant supine. Placing the infant in a supine position helps protect the surgical site from injury and promotes proper healing. Choice A, 'Position prone,' is incorrect as placing the infant prone can put pressure on the surgical site and hinder healing. Choice B, 'Provide fluids from a cup,' is not directly related to the surgical care of a cleft lip repair. Choice D, 'Avoid elbow restraints,' is not specific to the postoperative care of a cleft lip repair.

5. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?

• A. Spitting up
• B. Bilious vomiting
• C. Failure to thrive
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.

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