Nursing Elites

1. What assessment finding places a newborn at risk for developing physiologic jaundice?

• A. Cephalohematoma
• B. Mongolian spots
• C. Telangiectatic nevi
• D. Molding

Correct answer: A

Rationale: The correct answer is A, Cephalohematoma. Physiologic jaundice in newborns can occur due to the breakdown of excess red blood cells. A cephalohematoma, a collection of blood caused by ruptured blood vessels between a cranial bone's surface and periosteal membrane, can lead to increased red blood cell breakdown. This increased breakdown can contribute to the development of physiologic jaundice in newborns. Choices B, Mongolian spots, and C, Telangiectatic nevi, are both benign skin conditions and are not directly associated with increased red blood cell breakdown. Choice D, Molding, refers to the shaping of the fetal head during passage through the birth canal and is not related to the development of physiologic jaundice.

2. A toddler is admitted to the hospital because of sudden hoarseness, holding or pointing to their neck, and continuous cough. The nurse will be particularly concerned about:

• A. Acute respiratory tract infection
• B. Respiratory tract obstruction caused by a foreign body
• C. Retropharyngeal abscess
• D. Undetected laryngeal abnormality

Correct answer: B

Rationale: In a toddler presenting with sudden hoarseness, holding or pointing to their neck, and continuous cough, the nurse should be particularly concerned about respiratory tract obstruction caused by a foreign body. These symptoms are indicative of a possible foreign body in the airway, which can lead to serious complications and requires immediate attention to ensure the toddler's airway remains patent and unobstructed.

3. Which of the following statements regarding pediatric anatomy is correct?

• A. The child's trachea is more rigid and less prone to collapse.
• B. The occiput is proportionately larger when compared to an adult.
• C. Airway obstruction is common in children due to their large uvula.
• D. Relative to the overall size of the airway, a child's epiglottis is smaller.

Correct answer: B

Rationale: The occiput, the back part of the head, is proportionately larger in children compared to adults, which can have implications for airway management techniques. This anatomical difference is important to consider when providing care to pediatric patients, especially during airway interventions.

4. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?

• A. 5% dextrose infusion
• B. Normal saline infusion
• C. NPH insulin infusion
• D. Potassium infusion

Correct answer: B

Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.

5. What is the pattern of fever in enteric fever?

• A. Intermittent fever
• B. Relapsing fever
• C. Pel-Ebstein fever
• D. Continuous fever

Correct answer: D

Rationale: Enteric fever, caused by Salmonella typhi or paratyphi, is characterized by a continuous fever pattern. The fever typically persists without significant fluctuations, distinguishing it from diseases with intermittent or relapsing fever patterns. Pel-Ebstein fever, a cyclic pattern of fever seen in Hodgkin's lymphoma, is not associated with enteric fever. Relapsing fever is a characteristic of diseases like Borrelia recurrentis infection. Intermittent fever is seen in conditions like malaria.

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