Nursing Elites

1. In general, how much is a child that was 10 pounds at birth expected to weigh at 6 months old?

• A. Double = 20 lbs
• B.
• C.
• D.

Correct answer: A

Rationale: The correct answer is A. A child is expected to double their birth weight by 6 months. This is a common guideline used to monitor healthy growth and development in infants. Choices B, C, and D are incorrect as they do not provide the expected weight based on the given information.

2. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?

• A. It prevents the cremasteric reflex
• B. Undescended testes can be palpated
• C. The child has an inguinal hernia
• D. The child does not yet have a need for privacy

Correct answer: A

Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.

3. Which pediatric condition is characterized by a "string sign" on an upper GI series?

• A. Intussusception
• B. Hypertrophic pyloric stenosis
• C. Hirschsprung disease
• D. Meckel diverticulum

Correct answer: B

Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.

4. At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?

• A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
• B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
• C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
• D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.

Correct answer: D

Rationale: Encouraging the baby to fall asleep in the crib while still awake can help establish healthy sleep habits and reduce night waking.

5. Which of the following is the best indicator of a child's nutritional status?

• A. Weight
• B. Height
• C. Head circumference
• D. Mid-upper arm circumference

Correct answer: D

Rationale: Mid-upper arm circumference is a good indicator of muscle mass and fat stores, reflecting a child's nutritional status. It is particularly useful in assessing malnutrition, as it is less affected by fluid retention or dehydration compared to other anthropometric measurements. Weight can fluctuate due to factors like hydration status, making it less reliable as a sole indicator of nutritional status. Height reflects growth but may not directly indicate current nutritional status. Head circumference is more related to brain growth and development rather than overall nutritional status.

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