Nursing Elites

1. A young child has coarctation of the aorta. What does the nurse expect to identify when taking the child’s vital signs?

• A. A weak radial pulse
• B. An irregular heartbeat
• C. A bounding femoral pulse
• D. An elevated radial blood pressure

Correct answer: A

Rationale: In coarctation of the aorta, there is narrowing of the aorta leading to decreased blood flow distal to the constriction. This results in a weak or delayed femoral pulse and a relatively weaker radial pulse compared to the femoral pulse. An irregular heartbeat (choice B) is not a typical finding in coarctation of the aorta. A bounding femoral pulse (choice C) would not be expected due to the decreased blood flow beyond the constriction. An elevated radial blood pressure (choice D) is not a common characteristic of coarctation of the aorta; instead, blood pressure may be higher in the upper extremities compared to the lower extremities due to the constriction.

2. A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102°F, is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect the child has?

• A. Measles
• B. Chickenpox
• C. Fifth disease
• D. Scarlet fever

Correct answer: A

Rationale: The nurse should suspect measles in this child. The presence of a high fever, irritability, runny nose, rash, and Koplik spots (small, red spots with blue-white centers in the mouth) are classic signs of measles. Measles is a highly contagious viral illness that can lead to serious complications if not managed promptly. Chickenpox (choice B) presents with a different rash pattern and does not typically involve Koplik spots. Fifth disease (choice C) and scarlet fever (choice D) also have distinct clinical presentations and are not characterized by the specific symptoms described in this case.

3. 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 characterized by the blockage of the nasal passages, specifically the choanae that connect the nasal cavity to the nasopharynx. The nurse should assess the nasopharynx to identify any obstruction, confirm the diagnosis, and assess the severity of the condition. Choices A, C, and D are incorrect as they do not pertain to choanal atresia. Choanal atresia specifically involves the nasal passages and nasopharynx, not the rectum, intestinal tract, or laryngopharynx.

4. A healthcare provider is assessing a child with suspected bacterial meningitis. What is a common clinical manifestation that the provider is likely to observe?

• A. Rash
• B. Photophobia
• C. Jaundice
• D. Kernig sign

Correct answer: D

Rationale: A common clinical manifestation of bacterial meningitis is a positive Kernig sign, which indicates meningeal irritation. Kernig sign is elicited when the leg is bent at the hip and knee at 90-degree angles, and pain and resistance are felt with extension at the knee due to inflamed meninges. Options A, B, and C are not typically associated with bacterial meningitis. A rash is more commonly seen in viral illnesses, photophobia can be present but is not specific to bacterial meningitis, and jaundice is not a typical clinical manifestation of this condition.

5. A group of students is reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state:

• A. Endocrine glands begin developing during gestation.
• B. Endocrine glands are fully functional at birth.
• C. Infants may have difficulty regulating glucose and electrolytes.
• D. A child’s endocrine system plays a significant role in growth and development.

Correct answer: C

Rationale: The correct answer is C. Infants may have difficulty regulating glucose and electrolytes due to their immature endocrine systems. This can lead to issues such as hypoglycemia and electrolyte imbalances. Choice A is incorrect because endocrine glands actually begin developing early in gestation, not just in the third trimester. Choice B is incorrect as endocrine glands are not fully functional at birth; they continue to mature and develop after birth. Choice D is incorrect as a child's endocrine system has a significant impact on growth and development through the secretion of hormones that regulate various processes in the body, but it does not specifically address the difficulty in regulating glucose and electrolytes seen in infants.

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