Nursing Elites

1. What is the most common initial symptom of juvenile idiopathic arthritis?

• A. Joint swelling and pain
• B. Skin rash
• C. Gastrointestinal bleeding
• D. Neurological deficits

Correct answer: A

Rationale: The correct answer is A: Joint swelling and pain. These are the most common initial symptoms of juvenile idiopathic arthritis, typically affecting multiple joints. Skin rash (choice B), gastrointestinal bleeding (choice C), and neurological deficits (choice D) are not typical initial symptoms of juvenile idiopathic arthritis. Skin rash may be seen in other conditions like dermatitis or systemic lupus erythematosus, gastrointestinal bleeding may be associated with conditions like inflammatory bowel disease, and neurological deficits could be indicative of conditions like multiple sclerosis.

2. Which nutrient source yields more than 4 kcalories per gram?

• A. plant fats
• B. plant proteins
• C. animal proteins
• D. plant carbohydrates

Correct answer: A

Rationale: The correct answer is plant fats (Choice A). Fats, including plant fats, provide 9 kcalories per gram, which is more than 4 kcalories. Plant proteins (Choice B) and animal proteins (Choice C) provide 4 kcalories per gram. Plant carbohydrates (Choice D) also provide 4 kcalories per gram. Therefore, Choices B, C, and D are incorrect because they do not yield more than 4 kcalories per gram.

3. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

4. What is a key sign of meningitis in an infant?

• A. Increased appetite
• B. Bulging fontanel
• C. Decreased respiratory rate
• D. Elevated blood pressure

Correct answer: B

Rationale: A bulging fontanel is a key sign of meningitis in infants, indicating increased intracranial pressure due to inflammation of the meninges. This can lead to the fontanel bulging. Choices A, C, and D are incorrect. Increased appetite is not typically associated with meningitis in infants; instead, they may have poor feeding. A decreased respiratory rate is not a common sign of meningitis in infants. Elevated blood pressure is also not a typical finding in infants with meningitis.

5. How should a healthcare provider respond to a parent concerned about their child's sleep pattern?

• A. Recommend a sleep study
• B. Suggest increasing daytime naps
• C. Provide education on sleep hygiene
• D. Advise on medication use

Correct answer: C

Rationale: When a parent expresses concerns about their child's sleep pattern, providing education on sleep hygiene is a beneficial response. Teaching parents about establishing a consistent sleep routine, creating a conducive sleep environment, and promoting healthy sleep habits can help address the child's sleep issues. This empowers the parent to make positive changes that can improve the child's sleep patterns. Recommending a sleep study (Choice A) may be premature and unnecessary without first addressing basic sleep hygiene. Suggesting increasing daytime naps (Choice B) may not always be appropriate and could further disrupt the child's nighttime sleep. Advising on medication use (Choice D) should be considered only after other non-pharmacological approaches have been tried and if deemed necessary by a healthcare provider.

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