Nursing Elites

1. The caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse?

• A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately.
• B. The extrusion reflex must be developed and feeding solid foods will help the infant to develop this reflex.
• C. Breastfeeding will become painful when the infant gets more teeth, so the infant needs to eat solid foods.
• D. By this age the infant becomes interested in trying new skills.

Correct answer: A

Rationale: The correct response is A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately. Choice B is incorrect because the extrusion reflex is related to the tongue-thrust reflex, not the nutritional needs of the infant. Choice C is incorrect as breastfeeding does not become painful when the infant gets more teeth, and it is not a reason for introducing solid foods. Choice D is incorrect as the infant's interest in trying new skills is not a primary reason for introducing solid foods at this age.

2. Which pediatric disorder is associated with a 'boot-shaped' heart on a chest x-ray?

• A. Tetralogy of Fallot
• B. Transposition of the great arteries
• C. Coarctation of the aorta
• D. Ventricular septal defect

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot is often associated with a 'boot-shaped' heart appearance on a chest x-ray due to the characteristic heart anatomy in this condition. This appearance is caused by the combination of pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Choice B, Transposition of the great arteries, is incorrect because it presents with a 'egg-on-a-string' appearance on x-ray due to the abnormal position of the aorta and pulmonary artery. Choice C, Coarctation of the aorta, typically presents with rib notching on x-ray. Choice D, Ventricular septal defect, does not produce the 'boot-shaped' heart appearance seen in Tetralogy of Fallot.

3. The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe?

• A. Steatorrhea
• B. All are correct
• C. Malnutrition
• D. Foul-smelling stools

Correct answer: B

Rationale: Celiac disease often presents with steatorrhea, malnutrition, and foul-smelling stools due to the malabsorption of nutrients. Therefore, all the manifestations listed (steatorrhea, malnutrition, foul-smelling stools) are expected in a child with celiac disease. Polycythemia is not associated with celiac disease, making choice B the correct answer.

4. What is the most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants?

• A. Gastroesophageal reflux
• B. Respiratory distress
• C. Stricture formation
• D. Aspiration pneumonia

Correct answer: C

Rationale: The most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants is stricture formation. This complication occurs due to the healing process after surgery, leading to the narrowing of the esophagus. Gastroesophageal reflux (Choice A) can be a concern but is not the most common complication. Respiratory distress (Choice B) may happen but is not the primary complication. Aspiration pneumonia (Choice D) is a risk but is typically not as common as stricture formation in these cases.

5. An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?

• A. Renal colic
• B. Strong urinary stream
• C. Urinary tract infections
• D. Post urination dribbling

Correct answer: D

Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.

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