Nursing Elites

1. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

2. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?

• A. Child is in the concrete operational stage of cognition.
• B. Child’s dependence on peer influence is increasing.
• C. Child will welcome opportunities for participation in self-care.
• D. Child’s developmental stage involves achieving a sense of autonomy.

Correct answer: C

Rationale: The correct answer is C. At the age of 8, children are typically in the stage of industry vs. inferiority according to Erikson's psychosocial theory. This stage is characterized by a desire to engage in productive activities and take on responsibilities. Thus, the child will likely welcome opportunities for participation in self-care related to their diabetes management. Choices A, B, and D are incorrect. Choice A is inaccurate as children at this age are usually in the concrete operational stage of cognitive development, not abstract. Choice B is incorrect because while peer influence is significant, it has not reached its peak at this age. Choice D is wrong as achieving a sense of identity is a developmental task more commonly associated with adolescence, not 8-year-old children.

3. What is one of the most important factors that a healthcare professional must consider when parents of a toddler request to be present at a procedure occurring on the hospital unit?

• A. Type of procedure to be performed
• B. Individual assessment of the parents
• C. Whether the toddler wants the parents present
• D. Probable reaction to the toddler’s response to pain

Correct answer: B

Rationale: When parents of a toddler request to be present during a procedure, it is crucial to conduct an individual assessment of the parents. This assessment helps healthcare professionals understand the parents' ability to cope with the procedure, provide support to their child, and ensure a safe and comfortable environment for all involved. Choice A, the type of procedure to be performed, while important, is not the most critical factor in this scenario. Choice C, whether the toddler wants the parents present, is significant but secondary to assessing the parents themselves. Choice D, probable reaction to the toddler’s response to pain, is important but focuses more on the child's reaction rather than the parents' capacity to provide appropriate support.

4. What finding would lead the nurse to suspect that a child has Turner syndrome?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a key feature seen in Turner syndrome, a genetic condition that occurs in females due to a complete or partial absence of one of the X chromosomes. This physical trait is caused by excess skin on the neck, giving it a webbed appearance. Microcephaly (Choice B) is a condition characterized by a smaller than average head size and is not typically associated with Turner syndrome. Gynecomastia (Choice C) refers to breast enlargement in males and is not a common finding in Turner syndrome, which affects females. Cognitive delay (Choice D) is not a specific characteristic of Turner syndrome, as the syndrome primarily affects physical development and may not necessarily impact cognitive abilities.

5. What is the first action to take before administering tube feeding to an infant?

• A. Irrigate the tube with water.
• B. Offer a pacifier to the infant.
• C. Slowly instill 10 mL of formula.
• D. Place the infant in the Trendelenburg position.

Correct answer: B

Rationale: The correct first action before administering tube feeding to an infant is to offer a pacifier. Providing a pacifier stimulates the sucking reflex, aiding in digestion and providing comfort to the infant. Irrigating the tube with water (Choice A) is not typically the initial step and could potentially introduce unnecessary fluid into the infant's system. Slowly instilling formula (Choice C) should only be done after ensuring the tube is appropriately placed. Placing the infant in the Trendelenburg position (Choice D) is not necessary for tube feeding and could pose risks such as aspiration.

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