Nursing Elites

1. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

2. A child with sickle cell anemia is admitted to the hospital during a vaso-occlusive crisis. What is the most important intervention for the nurse to implement?

• A. Administering oxygen
• B. Ensuring adequate hydration
• C. Monitoring vital signs
• D. Administering pain medication

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, ensuring adequate hydration is crucial because it helps to reduce the viscosity of the blood and prevent further sickling of the cells. Administering oxygen may be necessary in some cases to improve tissue oxygenation, but hydration is the priority to prevent complications. Monitoring vital signs is important, but hydration takes precedence during a vaso-occlusive crisis. Administering pain medication is important for pain management but does not address the underlying issue of vaso-occlusion.

3. A 2-year-old child with a diagnosis of autism spectrum disorder is being discharged. What should the nurse include in the discharge teaching?

• A. Maintain a structured routine
• B. Encourage social interaction
• C. Use positive reinforcement
• D. Use a communication board

Correct answer: A

Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit from a structured routine as it provides them with stability and predictability, which can help reduce anxiety and improve behavior management. Encouraging social interaction (Choice B) may not be suitable for all children with autism, as some may struggle with social skills. While positive reinforcement (Choice C) is a helpful strategy, maintaining a structured routine is more essential for overall management in children with autism spectrum disorder. Using a communication board (Choice D) may be beneficial for communication, but establishing a structured routine is a foundational strategy that should be prioritized in the discharge teaching for a child with autism spectrum disorder.

4. What should the nurse recommend to reduce the risk of sudden infant death syndrome (SIDS) in a 6-month-old infant?

• A. Place the infant on their back to sleep
• B. Use a pacifier during sleep
• C. Have the infant sleep on their side
• D. Keep the infant's room cool

Correct answer: A

Rationale: Placing the infant on their back to sleep is the correct recommendation to reduce the risk of sudden infant death syndrome (SIDS). This sleep position has been shown to significantly decrease the incidence of SIDS. Using a pacifier during sleep (Choice B) can also help reduce the risk, but it is secondary to the back sleeping position. Having the infant sleep on their side (Choice C) is not recommended, as it increases the risk of SIDS. Keeping the infant's room cool (Choice D) may provide a comfortable sleeping environment but does not directly reduce the risk of SIDS.

5. The nurse is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?

• A. After a decade of escalation, the percentage of children living in low-income families has been on the decline since 2000.
• B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
• C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but a large increase is occurring in African American females.
• D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.

Correct answer: B

Rationale: Choice B is the correct answer because it accurately states that White, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This reflects a disparity in health outcomes among different racial groups. Choices A, C, and D are incorrect. Choice A is unrelated to the impact of common barriers to health care on families. Choice C talks about overweight children but does not address access to health care. Choice D discusses the impact of the overall health care plan on working families but does not specifically address the disparity in health status among different racial groups.

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