Nursing Elites

1. What is the primary symptom of congenital diaphragmatic hernia in a newborn?

• A. Cyanosis
• B. Bradycardia
• C. Absent breath sounds
• D. Tachypnea

Correct answer: C

Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.

2. What statement is an advantage of peritoneal dialysis compared with hemodialysis?

• A. Protein loss is less extensive.
• B. Dietary limitations are not necessary.
• C. It is easy to learn and safe to perform.
• D. It is needed less frequently than hemodialysis.

Correct answer: C

Rationale: Peritoneal dialysis is generally easier to learn and can be safely performed at home. Although dietary limitations still apply, this method offers greater flexibility in treatment scheduling compared to hemodialysis, which often requires multiple weekly visits to a dialysis center.

3. 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.

4. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

• A. 1 month
• B. 2 months
• C. 3 months
• D. 4 months

Correct answer: B

Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.

5. The nurse is caring for a 1-month-old infant diagnosed with Hirschsprung’s disease. Which treatment measure should be included in the plan of care?

• A. Barium Enema
• B. Surgical removal of the affected section of bowel
• C. High-fiber diet
• D. Permanent colostomy

Correct answer: B

Rationale: The correct answer is B: Surgical removal of the affected section of bowel. Hirschsprung's disease is a congenital condition where a portion of the large intestine lacks nerve cells, leading to difficulties in passing stool. The definitive treatment for this condition is the surgical removal of the affected section of the bowel. Barium enema (Choice A) may be used for diagnosis but is not a treatment. A high-fiber diet (Choice C) is not effective in managing Hirschsprung's disease. A permanent colostomy (Choice D) is not the initial treatment for this condition in infants.

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