Nursing Elites

1. A nurse is carrying on a conversation with a 7-year-old child during an office visit. Which is an example of the level of language development the nurse should expect in this child?

• A. Fascination with bathroom language
• B. Difficulty understanding the concept of 'half past' in reference to time
• C. Ability to carry on an adult conversation
• D. Inability to speak in full sentences

Correct answer: B

Rationale: The correct answer is B. Understanding time concepts like 'half past' can be challenging for a 7-year-old, indicating the level of language development. Choice A is incorrect as fascination with bathroom language is common in this age group but not necessarily indicative of language development. Choice C is incorrect as a 7-year-old typically cannot carry on an adult conversation due to cognitive and experiential limitations. Choice D is incorrect as by the age of 7, children should be able to speak in full sentences.

2. An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of defective utilization. The nurse understands that the reason for the FTT is most likely related to what?

• A. Cystic fibrosis
• B. Hyperthyroidism
• C. Congenital infection
• D. Breastfeeding problems

Correct answer: C

Rationale: FTT classified as defective utilization is often related to conditions like congenital infections, which interfere with the body's ability to effectively use nutrients. Conditions like cystic fibrosis and hyperthyroidism can also contribute to FTT but are categorized differently

3. What is the most critical physiological change required of newborns at birth?

• A. Transition from fetal to neonatal breathing
• B. Body temperature maintenance
• C. Stabilization of fluid and electrolytes
• D. Closure of fetal shunts in the heart

Correct answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The most critical physiological change required of newborns at birth is the initiation of breathing. This transition is crucial for the newborn to start exchanging oxygen and carbon dioxide outside the womb, marking the beginning of their independent respiratory function. Choices B, C, and D are important aspects of newborn care but are not as immediately critical as the establishment of breathing for oxygenation and removal of carbon dioxide, which is essential for the newborn's survival and adaptation to extrauterine life.

4. The nurse is caring for a child with an order of Ampicillin 250 mg IV in 30 mL of Normal Saline to infuse over 30 minutes. How many mL/hour should the nurse set the pump?

• A. 60
• B. 30
• C. 120
• D. 15

Correct answer: A

Rationale: The correct setting for the infusion pump should be 60 mL/hour to deliver 30 mL in 30 minutes. To calculate the infusion rate in mL/hour, divide the total volume to be infused (30 mL) by the total time for infusion (30 minutes) and then multiply by 60 to convert minutes to hours. Therefore, 30 mL / 30 minutes * 60 minutes/hour = 60 mL/hour. Choices B, C, and D are incorrect because they do not match the calculation based on the given parameters.

5. 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.

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