Nursing Elites

1. What is a common early sign of RSV (respiratory syncytial virus) in infants?

• A. High fever
• B. Nasal congestion
• C. Rash
• D. Jaundice

Correct answer: B

Rationale: Nasal congestion is a common early sign of RSV in infants, often accompanied by cough and wheezing. High fever, rash, and jaundice are not typically associated with RSV. While RSV can lead to fever, it is usually not one of the earliest signs. Rash and jaundice are unrelated to RSV symptoms.

2. What is a causative factor of Hirschsprung disease?

• A. Frequent evacuation of solids, liquids, and gases
• B. Excessive peristaltic movement
• C. Absence of parasympathetic ganglion cells in a portion of the colon
• D. One portion of the bowel telescoping into another

Correct answer: C

Rationale: The correct answer is C: Absence of parasympathetic ganglion cells in a portion of the colon. Hirschsprung disease is a congenital condition characterized by the absence of nerve cells (ganglia) in parts of the colon. This absence leads to a lack of peristalsis in the affected segment, resulting in severe constipation and bowel obstruction. Choices A, B, and D are incorrect. Choice A describes symptoms of diarrhea rather than a causative factor of Hirschsprung disease. Excessive peristaltic movement (choice B) is not a causative factor but rather the opposite, as Hirschsprung disease is associated with reduced peristalsis. Choice D, which refers to intussusception, is a different condition unrelated to Hirschsprung disease.

3. How should pain be assessed in a nonverbal child?

• A. Ask the parents about the child’s usual behavior
• B. Observe the child’s facial expressions and body movements
• C. Measure the child’s blood pressure
• D. Use a pain rating scale for older children

Correct answer: B

Rationale: Observing the nonverbal child's facial expressions and body movements is crucial in assessing pain. Nonverbal children may not be able to communicate their discomfort verbally, making it essential to rely on physical cues. Asking parents about the child's usual behavior (choice A) may provide some insight but observing the child directly is more direct and reliable. Measuring blood pressure (choice C) is not typically a direct method for assessing pain in nonverbal children. Using a pain rating scale designed for older children (choice D) is also inappropriate for nonverbal children who cannot participate in such self-reporting tools.

4. What is the primary goal in managing a child with cystic fibrosis?

• A. Increase dietary fat intake
• B. Prevent lung infections
• C. Increase physical activity
• D. Ensure high protein intake

Correct answer: B

Rationale: The primary goal in managing a child with cystic fibrosis is to prevent lung infections. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which increases the risk of infections. Preventing lung infections through proper respiratory care, medications, airway clearance techniques, and vaccinations is crucial in managing cystic fibrosis. While dietary interventions like increasing dietary fat intake, ensuring high protein intake, and promoting physical activity are also important aspects of cystic fibrosis management, preventing lung infections takes precedence as it directly addresses a major complication of the condition.

5. What action should be taken for a 2-year-old with laryngotracheobronchitis in an oxygen tent?

• A. Restrain the child and notify the healthcare provider
• B. Increase the oxygen concentration
• C. Take the child to the playroom
• D. Ask the mother to help in comforting the child

Correct answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

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