Nursing Elites

1. What dietary modification is recommended for a child with cystic fibrosis?

• A. High carbohydrate
• B. Low protein
• C. High calorie
• D. Low fat

Correct answer: C

Rationale: A high-calorie diet is recommended for children with cystic fibrosis due to their increased energy needs and malabsorption issues. Cystic fibrosis affects the pancreas, leading to poor digestion and absorption of nutrients, particularly fats, which requires dietary adjustments to maintain adequate nutrition. High carbohydrate (Choice A) is not the primary focus; the emphasis is on overall calorie intake. Low protein (Choice B) is not recommended as protein intake is essential for growth and development. Low fat (Choice D) is not the best option as fat-soluble vitamin absorption is already compromised in cystic fibrosis, hence fat restriction is not a priority.

2. A new dad is concerned about his toddler's play patterns. The nurse informs him that ____________ play is normally exhibited by toddlers:

• A. Associative
• B. Team
• C. Solitary
• D. Parallel

Correct answer: D

Rationale: The correct answer is D, 'Parallel.' Parallel play is a common play pattern observed in toddlers where they play alongside each other without direct interaction. This type of play allows toddlers to observe and mimic each other's actions, aiding in their social development. Choices A, B, and C are incorrect. Associative play involves some interaction between children, team play involves organized group activities, and solitary play is when a child plays alone, all of which are not typically exhibited by toddlers during play.

3. Which type of play would be most beneficial for preparing a preschool-age child for upcoming surgery to reduce the stress of the event?

• A. Cooperative play
• B. Associative play
• C. Dramatic play
• D. Onlooker play

Correct answer: C

Rationale: Dramatic play involves role-playing, allowing children to act out scenarios and become more comfortable with them. This type of play can help reduce anxiety about upcoming events like surgery. Cooperative play involves working together towards a common goal, associative play involves loosely interacting with others, and onlooker play involves observing others play without actively participating. These types of play are not as directly related to preparing a child for surgery and reducing stress as dramatic play.

4. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care would include what?

• A. Monitor closely for signs of infection.
• B. Place the child with the operative side of the head up.
• C. Avoid pumping the shunt reservoir to maintain patency.
• D. Avoid maintaining a Trendelenburg position to decrease pressure on the shunt.

Correct answer: A

Rationale: Postoperative nursing care for an infant with hydrocephalus who underwent ventriculoperitoneal shunt placement includes monitoring closely for signs of infection, as infection is the greatest hazard in the postoperative period. Signs of cerebrospinal fluid infection to watch for include elevated temperature, poor feeding, vomiting, decreased responsiveness, and seizure activity. The child should be placed with the operative side of the head up to reduce pressure on the valve. The shunt reservoir should not be pumped to maintain patency, as this can disrupt its function. Maintaining a Trendelenburg position to decrease pressure on the shunt is contraindicated as it can lead to increased intracranial pressure and compromise the shunt's effectiveness.

5. When assessing an infant with intussusception, what type of stool would the nurse expect to find?

• A. Soft, seedy stool
• B. Currant-jelly stool
• C. Ribbon-like stool
• D. Soft and pasty stool

Correct answer: B

Rationale: The correct answer is B: Currant-jelly stool. This type of stool, which is red and mucous-like, is a classic sign of intussusception in infants. Choice A (Soft, seedy stool) is incorrect as it does not specifically describe the characteristic stool associated with intussusception. Choice C (Ribbon-like stool) is incorrect; ribbon-like stool may be seen in conditions like colon cancer, not intussusception. Choice D (Soft and pasty stool) is also incorrect as it does not match the typical stool finding in intussusception.

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