Nursing Elites

1. Which nursing intervention provides the most support to the parents of an infant with an obvious physical anomaly?

• A. Encourage them to express their concerns.
• B. Discourage them from talking about their baby.
• C. Assure them not to worry because the anomaly can be repaired.
• D. Show them postoperative photographs of infants who had a similar anomaly.

Correct answer: A

Rationale: Encouraging parents to express their concerns is the most supportive intervention because it allows them to process their emotions and provides them with an opportunity to share their fears, anxieties, and questions. This open communication helps the nurse to offer appropriate support, education, and reassurance. Discouraging parents from talking about their baby (Choice B) can hinder their emotional expression and prevent them from seeking necessary information and support. Assuring parents not to worry (Choice C) may invalidate their feelings and minimize the significance of their concerns. Showing postoperative photographs (Choice D) may not be appropriate at this stage as parents need emotional support and education about the current situation before focusing on postoperative outcomes.

2. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect when palpating the infant’s abdomen?

• A. A distended colon
• B. Marked tenderness around the umbilicus
• C. An olive-sized mass in the right upper quadrant
• D. Rhythmic peristaltic waves in the lower abdomen

Correct answer: C

Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS due to the hypertrophied pylorus muscle. Choices A, B, and D are incorrect. A distended colon is not typically associated with HPS. Marked tenderness around the umbilicus is not a specific finding of HPS. Rhythmic peristaltic waves in the lower abdomen are not expected in HPS, as the condition primarily affects the pylorus region of the stomach.

3. A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn’t believe me.' Legally, who should the nurse notify?

• A. Police regarding a potential sex crime
• B. Health care provider to confirm the pregnancy
• C. Child Protective Services for immediate intervention
• D. The girl’s mother about the positive pregnancy test result

Correct answer: C

Rationale: In cases of child abuse and ongoing molestation, as described in the scenario, the primary concern is the safety and well-being of the child. Child Protective Services should be notified immediately for intervention to protect the girl and other children in the household from further harm. The police may be involved later to investigate the criminal aspect of the abuse. Notifying the healthcare provider solely to confirm the pregnancy or informing the girl’s mother about the positive test result does not address the urgent need for intervention and protection from abuse. Child Protective Services are trained to handle such cases and provide the necessary support and protection for the child and other vulnerable individuals in the family. Immediate action is crucial to ensure the girl's safety and prevent further harm.

4. A child with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing symptoms and ensuring proper nutrition in children with ADHD. Dietary factors can influence ADHD symptoms. While sleep patterns, academic performance, and behavior at home are important aspects to consider, dietary assessment plays a significant role in the management of ADHD.

5. A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?

• A. Rickets
• B. Obesity
• C. Anemia
• D. Rumination

Correct answer: B

Rationale: The correct answer is B: Obesity. Children with Down syndrome are at a higher risk of obesity due to various factors such as lower metabolic rate, hormonal imbalances, and reduced physical activity levels. Addressing healthy eating habits early can help prevent obesity in these children. Choice A (Rickets) is incorrect because rickets is primarily associated with vitamin D deficiency and is not a common nutritional problem in children with Down syndrome. Choice C (Anemia) is incorrect as anemia may not be a common nutritional problem specific to children with Down syndrome. Choice D (Rumination) is incorrect as rumination is a behavioral disorder characterized by repeated regurgitation of food and is not a common nutritional problem associated with Down syndrome.

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