Nursing Elites

1. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?

• A. Increased blood pressure
• B. A sunken fontanel
• C. Decreased pulse rate
• D. Low urine specific gravity

Correct answer: B

Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.

2. What self-report pain rating scales can be used in children as young as 3 years of age?

• A. Poker Chip Tool
• B. Visual Analog Scale
• C. FACES Pain Rating Scale
• D. Word-Graphic Rating Scale

Correct answer: C

Rationale: The FACES Pain Rating Scale is suitable for children as young as 3 years of age. It uses facial expressions to depict different levels of pain, making it easy for young children to understand and use. The Poker Chip Tool is validated for children aged 4 and older who have a certain level of cognitive ability. The Visual Analog Scale is more appropriate for children aged 7 and above. The Word-Graphic Rating Scale, which uses descriptive words, is recommended for children in the age range of 4 to 17 years.

3. The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse’s reply should be based on what?

• A. The child is too young to digest hot dogs.
• B. The child is too young to eat hot dogs safely.
• C. Hot dogs must be sliced into sections to prevent aspiration.
• D. Hot dogs must be cut into small, irregular pieces to prevent aspiration.

Correct answer: D

Rationale: Cutting hot dogs into small, irregular pieces reduces the risk of aspiration, which is a significant choking hazard for young children.

4. At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?

• A. Developmentally appropriate toys
• B. Nutritious snacks served to the children
• C. Handwashing by providers after diaper changes
• D. Certified caregivers for each of the age groups at the facility

Correct answer: C

Rationale: Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.

5. Which of the following is a hallmark sign of intussusception in children?

• A. Bilious vomiting
• B. "Currant jelly" stools
• C. Abdominal distention
• D. Constipation

Correct answer: B

Rationale: "Currant jelly" stools, consisting of mucus and blood, are characteristic of intussusception in children. It occurs due to the telescoping of a segment of the intestine into an adjacent segment, leading to obstruction and subsequent mucosal ischemia, causing the passage of bloody mucus in the stool. Bilious vomiting can be seen in other conditions like bowel obstruction, abdominal distention can be present but is not as specific, and constipation is less likely in the presentation of intussusception.

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