Nursing Elites

1. The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurse's intervention include?

• A. Explain the disorder so they can explain it to others.
• B. Help parents understand that this is a minor problem.
• C. Suggest that parents avoid family and friends until the gender is assigned.
• D. Encourage parents not to worry while the tests are being done.

Correct answer: A

Rationale: It is important for the nurse to provide the parents with accurate information so they can confidently explain the situation to others, helping to reduce stress and misinformation. Avoiding family and friends or minimizing the problem is not helpful.

2. Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?

• A. Vary the schedule for routine activities on a daily basis.
• B. Be persistent through 10 to 15 minutes of food refusal.
• C. Avoid solids until after the bottle is well accepted.
• D. Use developmental stimulation by a specialist during feedings.

Correct answer: B

Rationale: Being persistent through 10 to 15 minutes of food refusal is recommended to help increase caloric intake in infants with FTT. Establishing a routine and using developmental stimulation can also be helpful, but the priority is ensuring adequate caloric intake.

3. Which condition is most commonly associated with a 'sunset sign' in infants?

• A. Hydrocephalus
• B. Meningitis
• C. Cerebral palsy
• D. Encephalitis

Correct answer: A

Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'

4. Which statement regarding bottle mouth caries requires further teaching?

• A. Caries can be decreased by putting an infant to bed with a bottle of milk or sweetened juice
• B. Eliminating the bedtime bottle or substituting water is recommended
• C. Sugar pools within the oral cavity cause severe decay
• D. It is often seen in children between 18 months and 3 years

Correct answer: A

Rationale: The correct answer is A. Putting an infant to bed with a bottle of milk or sweetened juice increases the risk of bottle mouth caries rather than decreasing it. This statement requires further teaching as it provides incorrect information. Choice B is correct as eliminating the bedtime bottle or substituting water is recommended to prevent bottle mouth caries. Choice C is also correct as sugar pooling within the oral cavity can indeed cause severe decay. Choice D is correct as bottle mouth caries is often observed in children between 18 months and 3 years.

5. 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.

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