Nursing Elites

1. What problem is most often associated with myelomeningocele?

• A. Biliary atresia
• B. Hydrocephalus
• C. Craniostenosis
• D. Tracheoesophageal fistula

Correct answer: B

Rationale: Hydrocephalus is the most commonly associated problem with myelomeningocele, present in 80% to 90% of affected children. Biliary atresia and tracheoesophageal fistula are not typically associated with myelomeningocele. Craniostenosis refers to the premature closing of cranial sutures and is not a common issue seen with myelomeningocele.

2. Which laboratory test would be most important for the nurse to assess when caring for a toddler suspected of having cystic fibrosis?

• A. Liver enzymes
• B. Serum calcium
• C. Sweat chloride test
• D. Urine creatinine

Correct answer: C

Rationale: The sweat chloride test is the primary diagnostic test for cystic fibrosis. Cystic fibrosis is characterized by abnormal transport of chloride and sodium across epithelial cell membranes, leading to increased chloride in sweat. This test is crucial for diagnosing cystic fibrosis in suspected cases. Liver enzymes (Choice A), serum calcium (Choice B), and urine creatinine (Choice D) are not specific tests for cystic fibrosis and would not provide the necessary information for diagnosis in this case.

3. The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

• A. A white reflex
• B. Blue-tinged sclerae
• C. A red reflex
• D. Yellow-tinged sclerae

Correct answer: A

Rationale: The correct answer is A: A white reflex. The 'white reflex' or leukocoria is a common sign of retinoblastoma. It occurs when the light reflects off the tumor in the eye, giving the pupil a white appearance instead of the normal red reflex. Blue-tinged sclerae (choice B) and yellow-tinged sclerae (choice D) are not typical manifestations of retinoblastoma. A red reflex (choice C) is the normal reflection seen in the eye when light is shone on it and is not associated with retinoblastoma.

4. As children grow and develop, their style of play changes. Which play style is seen in the preschooler?

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

Correct answer: B

Rationale: The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.

5. Which disease requires strict isolation due to its mode of transmission?

• A. Mumps
• B. Chickenpox
• C. Exanthema subitum (roseola)
• D. Erythema infectiosum (fifth disease)

Correct answer: B

Rationale: The correct answer is Chickenpox (choice B). Chickenpox is highly communicable and requires strict isolation to prevent the spread of the virus through direct contact, droplet transmission, and contaminated objects. Mumps (choice A) is also contagious but does not typically require strict isolation. Exanthema subitum (roseola) (choice C) and Erythema infectiosum (fifth disease) (choice D) are not as highly contagious as chickenpox and do not necessitate strict isolation.

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