Nursing Elites

1. Which pediatric disorder is associated with a 'boot-shaped' heart on a chest x-ray?

• A. Tetralogy of Fallot
• B. Transposition of the great arteries
• C. Coarctation of the aorta
• D. Ventricular septal defect

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot is often associated with a 'boot-shaped' heart appearance on a chest x-ray due to the characteristic heart anatomy in this condition. This appearance is caused by the combination of pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Choice B, Transposition of the great arteries, is incorrect because it presents with a 'egg-on-a-string' appearance on x-ray due to the abnormal position of the aorta and pulmonary artery. Choice C, Coarctation of the aorta, typically presents with rib notching on x-ray. Choice D, Ventricular septal defect, does not produce the 'boot-shaped' heart appearance seen in Tetralogy of Fallot.

2. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

• A. Advise bed rest until 1 week after the icteric phase.
• B. Teach infection control measures to family members.
• C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
• D. Reassure the mother that hepatitis A cannot be transmitted to other family members.

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

3. 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.

4. The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.)

• A. Asthma
• B. Hypertension
• C. Dyslipidemia
• D. All of the above

Correct answer: D

Rationale: Obesity increases the risk for conditions like asthma, hypertension, dyslipidemia, and altered glucose metabolism, but not typically irritable bowel disease.

5. Which food should be introduced first to a 6-month-old infant?

• A. Fruits
• B. Eggs
• C. Vegetables
• D. Meat

Correct answer: C

Rationale: Vegetables, particularly pureed ones, are often recommended as a first solid food for infants because they are easy to digest and less likely to cause allergies. Fruits can be introduced later due to their natural sweetness, while eggs and meat are typically introduced after fruits and vegetables as they may pose a higher risk of allergies.

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