Nursing Elites

1. What is a physical characteristic of infants whose mothers smoked during pregnancy?

• A. Being large for gestational age
• B. Growth restriction in weight only
• C. Preterm but size appropriate for gestational age
• D. Growth restriction in weight, length, and chest and head circumference

Correct answer: D

Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.

2. A 5-year-old is hospitalized with a fractured femur. Which pain assessment tool is appropriate for this child?

• A. CRIES Scale
• B. Faces Pain Rating Scale
• C. SUN Scale
• D. NIPS Scale

Correct answer: B

Rationale: The Faces Pain Rating Scale is appropriate for assessing pain in children who can express their feelings visually. For a 5-year-old child who can communicate effectively, using a tool like the Faces Pain Rating Scale, which uses facial expressions to indicate pain levels, is more suitable than the CRIES Scale (used for neonates), the SUN Scale (used for infants), or the NIPS Scale (used for preterm and term newborns).

3. What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

• A. Fever
• B. Hypotension
• C. All are applicable
• D. Swelling and tenderness of graft area

Correct answer: B

Rationale: Signs of kidney transplant rejection include fever, diminished urinary output, and swelling/tenderness in the graft area. These symptoms indicate that the body may be rejecting the transplanted organ, requiring immediate medical attention.

4. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

• A. Safe administration of daily enemas
• B. Necessity of firm stools to keep suture line clean
• C. Bowel training beginning as soon as the child returns home
• D. Changes in stooling patterns to report to the practitioner

Correct answer: D

Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.

5. The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?

• A. Pain is common.
• B. Weight loss is severe.
• C. All are correct.
• D. Diarrhea is moderate to severe.

Correct answer: C

Rationale: The correct answer is C because Crohn's disease commonly presents with pain, severe weight loss, and moderate to severe diarrhea in affected individuals. Therefore, all the manifestations listed are typically observed in patients with Crohn's disease. Choice A alone is not sufficient as weight loss and diarrhea are also prominent symptoms. Choice B is incorrect as it only mentions weight loss, omitting other common manifestations. Choice D is also incorrect as it does not cover the full range of expected clinical signs in Crohn's disease.

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