Nursing Elites

1. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?

• A. Circulatory collapse, hypovolemia
• B. Cardiomegaly, systolic murmur
• C. Hepatomegaly, intrahepatic cholestasis
• D. Painful swelling of joints in hands and feet, tissue engorgement

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.

2. What is a common cause of acquired aplastic anemia in children?

• A. Deficient diet
• B. Ingestion of drugs such as chloramphenicol or antiepileptics
• C. Congenital defects
• D. Injury

Correct answer: B

Rationale: The correct answer is B. Acquired aplastic anemia in children is often caused by exposure to certain drugs, such as chloramphenicol or antiepileptics, which can lead to bone marrow failure and a decrease in all types of blood cells. Choices A, C, and D are incorrect because aplastic anemia is not commonly caused by deficient diet, congenital defects, or injury in children.

3. What is an essential nursing care intervention for a neonate with a suspected tracheoesophageal fistula?

• A. Feed glucose water only.
• B. Elevate the patient's head for feedings.
• C. Raise the patient's head and give nothing by mouth.
• D. Avoid suctioning unless the infant is cyanotic.

Correct answer: C

Rationale: Raising the patient’s head and giving nothing by mouth is crucial in managing tracheoesophageal fistula. This intervention helps prevent aspiration and further complications until surgical correction can be performed. Feeding the neonate or suctioning could exacerbate the condition by risking aspiration. Elevating the head for feedings does not address the primary concern of preventing oral intake, making it less appropriate than the correct answer.

4. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?

• A. Respond to name
• B. React to loud noise with Moro reflex
• C. Turn his or her head to side when sound is at ear level
• D. Locate sound by turning his or her head in a curving arc

Correct answer: B

Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.

5. What is the most effective way to prevent the spread of hand, foot, and mouth disease in a daycare setting?

• A. Handwashing
• B. Isolating sick children
• C. Disinfecting toys
• D. Encouraging vaccination

Correct answer: A

Rationale: Handwashing is indeed the most effective way to prevent the spread of hand, foot, and mouth disease in children. Proper hand hygiene helps in removing and killing germs that can cause infections. While isolating sick children and disinfecting toys are important measures to prevent the spread of diseases, they are not as effective as handwashing. Encouraging vaccination, in this case, is not relevant since there is no specific vaccine available for hand, foot, and mouth disease.

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