Nursing Elites

1. Which sign is indicative of developmental dysplasia of the hip in infants?

• A. Ortolani sign
• B. Romberg sign
• C. Trendelenburg sign
• D. Gower's sign

Correct answer: A

Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.

2. Evidence-based practice (EBP), a decision-making model, is best described as which?

• A. Using information in textbooks to guide care
• B. Combining knowledge with clinical experience and intuition
• C. Using a professional code of ethics as a means for decision-making
• D. Gathering all evidence that applies to the child’s health and family situation

Correct answer: D

Rationale: Evidence-based practice involves gathering and integrating all relevant evidence to guide clinical decision-making, ensuring that care is based on the best available research.

3. A new parent, when asked by a nurse, explains that the 4-month-old infant has been nursing regularly every 3 to 4 hours and seems satisfied. However, the parent recently introduced solid food in the form of unbuttered popcorn to the infant as a supplement. What should be the primary nursing concern in this situation?

• A. Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food
• B. Risk for aspiration related to feeding the infant an inappropriate food
• C. Imbalanced nutrition, less than body requirements, related to introduction of a low-nutritive food
• D. Readiness for enhanced nutrition, related to the age of the infant

Correct answer: B

Rationale: The primary nursing concern in this situation is the risk for aspiration. Popcorn is a choking hazard for infants, as their airway is not fully developed to handle solid foods like popcorn. Choices A, C, and D are incorrect because the main focus should be on the immediate risk of aspiration due to the inappropriate solid food given to the infant, rather than on nutritional imbalances or readiness for enhanced nutrition.

4. A new mom is ready to introduce solid foods to her infant. Which food would you recommend starting with?

• A. Meat
• B. Rice cereal
• C. Fruits
• D. Vegetables

Correct answer: B

Rationale: The correct answer is B: Rice cereal. Rice cereal is typically the first solid food introduced to infants because it is easy to digest and unlikely to cause an allergic reaction. Starting with rice cereal helps assess the baby's readiness for solid foods and reduces the risk of allergic responses. Choice A (Meat) is not recommended as the initial solid food due to its higher allergenic potential. Choices C (Fruits) and D (Vegetables) are also not usually recommended as the first solid food, as they may be more challenging for infants to digest compared to rice cereal.

5. What is an approximate method of estimating output for a child who is not toilet trained?

• A. Have parents estimate output.
• B. Weigh diapers after each void.
• C. Place a urine collection device on the child.
• D. Have the child sit on a potty chair 30 minutes after eating.

Correct answer: B

Rationale: Weighing diapers is the most accurate way to estimate urine output in a child who is not toilet trained. This method provides a measurable and reliable estimate of fluid output.

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