Nursing Elites

1. The charge nurse in the pediatric unit is teaching nursing students about pyloric stenosis. A student asks what causes pyloric stenosis. How should the nurse respond?

• A. One portion of the intestines invaginates or telescopes into another
• B. Hypertrophy of the circular pylorus muscle
• C. Relaxed cardiac sphincter
• D. Absent ganglion cells in the colon

Correct answer: B

Rationale: Pyloric stenosis is caused by the hypertrophy (thickening) of the circular muscle of the pylorus, leading to obstruction. Choice A is incorrect as it describes intussusception, not pyloric stenosis. Choice C is incorrect as a relaxed cardiac sphincter is related to gastroesophageal reflux. Choice D is incorrect as it describes Hirschsprung's disease, not pyloric stenosis.

2. Which vaccine is contraindicated in a child with a history of severe egg allergy?

• A. MMR
• B. Varicella
• C. Influenza
• D. Hepatitis B

Correct answer: C

Rationale: The correct answer is C: Influenza. The influenza vaccine is produced using egg-based technology, so individuals with a severe egg allergy are at risk of an allergic reaction if vaccinated with the influenza vaccine. This is due to the potential presence of egg proteins in the vaccine. Choices A, B, and D are not contraindicated in children with severe egg allergy. The MMR and Varicella vaccines do not pose a risk for children with egg allergies, and the Hepatitis B vaccine is also safe for these individuals.

3. The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?

• A. 2 to 3 years
• B. 4 to 5 years
• C. 6 to 7 years
• D. 8 to 9 years

Correct answer: B

Rationale: The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.

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 nurse is preparing to feed a 10-month-old child diagnosed with failure to thrive (FTT). Which actions should the nurse plan to implement?

• A. Be persistent.
• B. Introduce new foods slowly.
• C. All are correct
• D. Maintain a calm, even temperament.

Correct answer: C

Rationale: Persistence in feeding, introducing new foods slowly, and maintaining a calm temperament are key strategies in managing FTT. A stimulating atmosphere may overwhelm the child and should be minimized during feeding times.

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