Nursing Elites

1. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?

• A. Clay-colored stools and dark urine
• B. History of early passage of meconium in the newborn period
• C. History of chronic, progressive constipation and failure to gain weight
• D. Continual bouts of foul-smelling diarrhea

Correct answer: C

Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.

2. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?

• A. 0.9% normal saline (NS)
• B.
• C. D5W
• D. Albumin

Correct answer: A

Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.

3. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

• A. Elevate the head of the child's bed
• B. Insert a large-bore IV catheter for the child
• C. Determine the allergen that caused the child's reaction
• D. Administer IM epinephrine to the child

Correct answer: D

Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.

4. What is functional behavior analysis?

• A. Systematic observation of behavior
• B. Standardized assessment
• C. Multiple choice examination
• D. Parent-teacher questionnaire

Correct answer: A

Rationale: Functional behavior analysis involves systematically observing behavior to understand its function and context. It focuses on identifying the antecedents and consequences that maintain or influence behavior. This systematic observation helps in determining patterns, triggers, and maintaining factors of behavior. Standardized assessments (choice B) involve using specific tools or tests to measure a person's performance or behavior but do not focus on observation. Multiple choice examinations (choice C) and parent-teacher questionnaires (choice D) are not synonymous with functional behavior analysis as they do not involve direct observation of behavior for analysis.

5. A healthcare professional is preparing to collect a sample from a toddler for a sickle turbidity test. Which of the following actions should the healthcare professional plan to take?

• A. Obtain a sputum specimen
• B. Perform an Allen test
• C. Perform a finger stick
• D. Obtain a stool specimen

Correct answer: C

Rationale: The healthcare professional should perform a finger stick on a toddler as a component of the sickle turbidity test. If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease. Finger stick is a common method used to collect blood samples, especially in pediatric patients, for various tests.

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