Nursing Elites

1. A newborn is admitted to the neonatal intensive care unit (NICU) with choanal atresia. Which part of the infant’s body should the nurse assess?

• A. Rectum
• B. Nasopharynx
• C. Intestinal tract
• D. Laryngopharynx

Correct answer: B

Rationale: Choanal atresia is a congenital condition that presents with a blockage in the nasal passages at the junction of the nasal cavity and the nasopharynx. To assess and confirm the diagnosis of choanal atresia, the nurse should focus on assessing the nasopharynx. Choices A, C, and D are incorrect as choanal atresia specifically involves a blockage in the nasal passages, not the rectum, intestinal tract, or laryngopharynx. By assessing the nasopharynx, the severity of the obstruction can be determined, aiding in planning appropriate interventions for the newborn.

2. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

3. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

• A. The child has a maculopapular rash on his palms.
• B. The parents report that their son is vomiting and not eating well.
• C. The parents report that their son is irritable and not gaining weight.
• D. Auscultation reveals wheezing with diminished lung sounds.

Correct answer: B

Rationale: Vomiting and poor appetite are common symptoms of neuroblastoma, a malignancy that arises from neural crest cells in the adrenal glands or sympathetic nervous system. This tumor can cause abdominal swelling due to its location and size, leading to symptoms like vomiting and decreased appetite. The presence of a maculopapular rash on the palms (Choice A) is not a typical finding associated with neuroblastoma. Irritability and failure to thrive (Choice C) are nonspecific symptoms that can be seen in various conditions but are not specifically indicative of neuroblastoma. Auscultation revealing wheezing with diminished lung sounds (Choice D) may suggest respiratory conditions rather than neuroblastoma.

4. What information should be included in the preoperative plan of care for an infant with myelomeningocele?

• A. Positioning the infant supine with a pillow under the buttocks
• B. Covering the sac with saline-soaked nonadhesive gauze
• C. Wrapping the infant snugly in a blanket
• D. Applying a diaper to prevent fecal soiling of the sac

Correct answer: B

Rationale: Covering the sac with saline-soaked nonadhesive gauze is essential in the preoperative care of an infant with myelomeningocele. This practice helps prevent infection and maintains moisture around the sac before surgery, promoting optimal healing outcomes. Positioning the infant supine with a pillow under the buttocks may be uncomfortable and unnecessary. Wrapping the infant snugly in a blanket does not address the specific care needs of the myelomeningocele. Applying a diaper over the sac can increase the risk of infection and should be avoided in this case.

5. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?

• A. Encourage participation in physical activity
• B. Provide a high-calorie diet
• C. Provide a low-sodium diet
• D. Administer intravenous fluids

Correct answer: A

Rationale: Encouraging regular physical activity is essential in managing symptoms and improving joint function in juvenile idiopathic arthritis. Physical activity helps maintain joint mobility, muscle strength, and overall function. Providing a high-calorie diet may not be necessary unless there are specific concerns about the child's nutritional status. A low-sodium diet is not typically a priority in the management of JIA unless the child has comorbid conditions requiring sodium restriction. Administering intravenous fluids is not a standard discharge teaching for JIA unless there are specific medical indications necessitating it.

Similar Questions