Nursing Elites

1. Which pediatric condition is characterized by a "string sign" on an upper GI series?

• A. Intussusception
• B. Hypertrophic pyloric stenosis
• C. Hirschsprung disease
• D. Meckel diverticulum

Correct answer: B

Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.

2. As children grow and develop, their style of play changes. Which play style is seen in the preschooler?

• A. Solitary
• B. Associative
• C. Cooperative
• D. Parallel

Correct answer: B

Rationale: The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.

3. The nurse is planning an educational session for a group of 9-year-olds and their parents aimed at decreasing injuries and accidents among this age group. Which topics should be included in the educational session to accomplish the goal?

• A. Safety rules when dealing with fire to prevent burns.
• B. Safety rules when dealing with toxic substances to prevent poisonings.
• C. Pedestrian, motor vehicle, and bike safety rules.
• D. Safety information regarding the use of all-terrain vehicles (ATVs).

Correct answer: C

Rationale: For school-aged children, pedestrian, motor vehicle, and bike safety are critical areas to focus on as accidents involving these are common in this age group. Education about fire safety and toxic substances is also important, but the priority is on preventing accidents in everyday activities. Therefore, choices A, B, and D are not the most relevant for addressing the goal of decreasing injuries and accidents in this age group.

4. Which statement regarding bottle mouth caries requires further teaching?

• A. Caries can be decreased by putting an infant to bed with a bottle of milk or sweetened juice
• B. Eliminating the bedtime bottle or substituting water is recommended
• C. Sugar pools within the oral cavity cause severe decay
• D. It is often seen in children between 18 months and 3 years

Correct answer: A

Rationale: The correct answer is A. Putting an infant to bed with a bottle of milk or sweetened juice increases the risk of bottle mouth caries rather than decreasing it. This statement requires further teaching as it provides incorrect information. Choice B is correct as eliminating the bedtime bottle or substituting water is recommended to prevent bottle mouth caries. Choice C is also correct as sugar pooling within the oral cavity can indeed cause severe decay. Choice D is correct as bottle mouth caries is often observed in children between 18 months and 3 years.

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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