Nursing Elites

1. When taking a child’s blood pressure, what percentage of the upper arm should the nurse ensure the cuff bladder width covers?

• A. 20%
• B. 40%
• C. 60%
• D. 80%

Correct answer: B

Rationale: When taking a child's blood pressure, the nurse should select a cuff with a bladder width that covers 40% of the arm circumference at the midpoint of the upper arm. This ensures accurate readings. Choosing a cuff that covers less or more than 40% can lead to incorrect blood pressure measurements. Therefore, options A, C, and D are incorrect.

2. An infant is diagnosed with a tracheoesophageal fistula. Which assessment finding should the nurse expect?

• A. Jaundice
• B. Hyperactive bowel sounds
• C. Absence of sucking, vomiting
• D. Coughing, with excessive secretion

Correct answer: D

Rationale: Coughing with excessive secretion is a common sign of tracheoesophageal fistula. In this condition, the connection between the trachea and esophagus allows saliva and food to enter the airways, leading to coughing and excessive secretions. Choice A, jaundice, is not typically associated with tracheoesophageal fistula. Hyperactive bowel sounds (Choice B) are more likely seen in conditions like gastroenteritis. Absence of sucking and vomiting (Choice C) is not a typical finding related to tracheoesophageal fistula.

3. What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?

• A. Pyloric stenosis
• B. Intussusception
• C. Hirschsprung disease
• D. Celiac disease

Correct answer: C

Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.

4. The school nurse is teaching a group of adolescents about avoiding contaminated water during a mission trip. What should the nurse include in the teaching?

• A. Ice
• B. All are applicable
• C. Raw vegetables
• D. Unpeeled fruits

Correct answer: B

Rationale: The correct answer is B: All are applicable. Ice, raw vegetables, and unpeeled fruits can be sources of contamination in areas where water purity is questionable. It's safer to avoid these during a mission trip to prevent waterborne illnesses. Choice A (Ice), C (Raw vegetables), and D (Unpeeled fruits) are all potential sources of contamination in areas with questionable water quality. Including all these items in the teaching will help adolescents make informed decisions to stay healthy during their mission trip.

5. Which is a consequence of the physical punishment of children, such as spanking?

• A. The psychological impact is usually minimal.
• B. The child's development of reasoning increases.
• C. Children rarely become accustomed to spanking.
• D. Misbehavior is likely to occur when parents are not present.

Correct answer: D

Rationale: Physical punishment, such as spanking, may result in children misbehaving when parents are not present, as it does not teach appropriate behavior or self-regulation.

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