Nursing Elites

1. Physiological anorexia in toddlerhood occurs because of:

• A. Decreased appetite and decreased nutritional need
• B. Decreased appetite and increased nutritional need
• C. Increased appetite and lack of food preferences
• D. Increased appetite and strong food preferences

Correct answer: A

Rationale: Physiological anorexia in toddlers occurs due to a decreased appetite as growth rates slow down. Choice A is correct because it aligns with the concept that toddlers experience a natural decrease in appetite as their growth rate decreases. Choices B, C, and D are incorrect because they suggest increased appetite or other factors not associated with physiological anorexia in toddlerhood.

2. When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

• A. Anorexia
• B. Bradycardia
• C. Sudden relief from pain
• D. Decreased abdominal distention

Correct answer: C

Rationale: When caring for a child with probable appendicitis, sudden relief from pain is a critical sign that could indicate perforation of the appendix. Perforation results in the release of pressure and inflammation, leading to a temporary relief of pain. Anorexia (loss of appetite) and decreased abdominal distention are symptoms commonly associated with appendicitis itself, not perforation. Bradycardia (slow heart rate) is not typically a direct manifestation of appendicitis or its complications.

3. A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs?

• A. The infant's IV line has infiltrated.
• B. The infant has not voided since surgery.
• C. The infant's mother states the infant is tolerating the feeding okay.
• D. The infant is taking the Pedialyte without vomiting or distention.

Correct answer: D

Rationale: The decision to advance feedings after a pyloromyotomy is based on the infant's ability to tolerate the current feedings without vomiting or abdominal distention. Ensuring the infant can keep down Pedialyte is the key indicator for moving to the next stage of feeding. Choices A, B, and C are incorrect because they do not directly relate to the infant's ability to tolerate the feeding. An infiltrated IV line, lack of voiding, or the mother's statement do not provide direct information on the infant's tolerance to the feeding, unlike the absence of vomiting and distention.

4. Which assessment findings should the nurse expect in a child with sickle cell anemia experiencing an acute vaso-occlusive crisis?

• A. Circulatory collapse, hypovolemia
• B. Cardiomegaly, systolic murmur
• C. Hepatomegaly, intrahepatic cholestasis
• D. Painful swelling of joints in hands and feet, tissue engorgement

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia are characterized by painful swelling of the joints in the hands and feet (hand-foot syndrome) and tissue engorgement due to the obstruction of blood flow by sickled cells. Choices A, B, and C are incorrect because circulatory collapse, hypovolemia, cardiomegaly, systolic murmur, hepatomegaly, and intrahepatic cholestasis are not typically associated with an acute vaso-occlusive crisis in sickle cell anemia.

5. The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse’s reply should be based on what?

• A. The child is too young to digest hot dogs.
• B. The child is too young to eat hot dogs safely.
• C. Hot dogs must be sliced into sections to prevent aspiration.
• D. Hot dogs must be cut into small, irregular pieces to prevent aspiration.

Correct answer: D

Rationale: Cutting hot dogs into small, irregular pieces reduces the risk of aspiration, which is a significant choking hazard for young children.

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