Nursing Elites

1. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

• A. Chromosome analysis will be complete in 7 days.
• B. A physical examination will be able to provide a definitive answer.
• C. Additional laboratory testing is necessary to assign the correct gender.
• D. Gender assignment involves collaboration between the parents and a multidisciplinary team.

Correct answer: D

Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.

2. What is a classic sign of congenital hypothyroidism in newborns?

• A. Jaundice
• B. Hypothermia
• C. Prolonged jaundice
• D. Excessive crying

Correct answer: C

Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.

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. The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?

• A. Inform toddlers about an upcoming procedure 2 hours before the procedure is to be performed.
• B. Inform school-age children about an upcoming procedure immediately before the procedure is scheduled to occur.
• C. Discourage parent presence during procedures on infants and toddlers.
• D. Use simple diagrams of anatomy and physiology to explain a procedure to a school-age child.

Correct answer: D

Rationale: Using simple diagrams helps school-age children understand what to expect in a procedure, catering to their developmental level and reducing anxiety. Informing toddlers too early can increase anxiety, and parents' presence is generally comforting, not discouraging.

5. What is an important intervention in providing a neutral thermal environment for an LBW infant in an incubator?

• A. Use wool blankets.
• B. Avoid using disposable diapers.
• C. Prevent heat loss.
• D. Closely monitor both incubator and rectal temperatures.

Correct answer: C

Rationale: Preventing heat loss in a low birth weight (LBW) infant is crucial in maintaining a neutral thermal environment. The use of cotton blankets is recommended over wool blankets. Avoiding disposable diapers is not directly related to maintaining a neutral thermal environment. While monitoring temperatures is important, the key intervention is preventing heat loss to ensure the infant's survival.

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