Nursing Elites

1. Two children are working on a puzzle together in the hospital playroom. Which type of play describes this activity?

• A. Solitary play
• B. Associative play
• C. Parallel play
• D. Cooperative play

Correct answer: D

Rationale: The correct answer is D, cooperative play. In cooperative play, children work together toward a common goal, such as completing a puzzle. Solitary play (A) is when a child plays alone, associative play (B) involves children playing together but without a common goal, and parallel play (C) is when children play alongside each other without direct interaction.

2. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

• A. Keep buttons, beads, and other small objects out of his reach.
• B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
• C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
• D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.

Correct answer: A

Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.

3. What is the leading cause of morbidity and mortality in children with cystic fibrosis?

• A. Respiratory infections
• B. Malnutrition
• C. Diabetes
• D. Liver disease

Correct answer: A

Rationale: Respiratory infections are the leading cause of morbidity and mortality in children with cystic fibrosis. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which predisposes these children to recurrent respiratory infections. Malnutrition and diabetes are common comorbidities in cystic fibrosis but are not the leading causes of morbidity and mortality in affected children. Liver disease can occur in cystic fibrosis but is less common than respiratory complications.

4. What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?

• A. Pyloric stenosis
• B. Intussusception
• C. Hirschsprung disease
• D. Celiac disease

Correct answer: C

Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.

5. Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?

• A. Feet and hands
• B. Bridge of nose
• C. Circumoral area
• D. Mucous membranes

Correct answer: A

Rationale: Nonpathologic cyanosis in newborns shortly after birth is typically present in the feet and hands, known as acrocyanosis. This is a normal finding due to the immature peripheral circulation in newborns. Cyanosis of the bridge of the nose, circumoral area, and mucous membranes indicates generalized cyanosis, which suggests a potential underlying distress or major abnormality. Therefore, choice A is correct as it describes the expected location for nonpathologic cyanosis in newborns, while choices B, C, and D represent areas associated with abnormal cyanosis.

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