Nursing Elites

1. 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.

2. What is a causative factor of Hirschsprung disease?

• A. Frequent evacuation of solids, liquids, and gases
• B. Excessive peristaltic movement
• C. Absence of parasympathetic ganglion cells in a portion of the colon
• D. One portion of the bowel telescoping into another

Correct answer: C

Rationale: The correct answer is C: Absence of parasympathetic ganglion cells in a portion of the colon. Hirschsprung disease is a congenital condition characterized by the absence of nerve cells (ganglia) in parts of the colon. This absence leads to a lack of peristalsis in the affected segment, resulting in severe constipation and bowel obstruction. Choices A, B, and D are incorrect. Choice A describes symptoms of diarrhea rather than a causative factor of Hirschsprung disease. Excessive peristaltic movement (choice B) is not a causative factor but rather the opposite, as Hirschsprung disease is associated with reduced peristalsis. Choice D, which refers to intussusception, is a different condition unrelated to Hirschsprung disease.

3. What should be monitored in a child with congenital adrenal hyperplasia (CAH)?

• A. Blood glucose levels
• B. Electrolyte balance
• C. Urine output
• D. Hemoglobin levels

Correct answer: B

Rationale: In a child with congenital adrenal hyperplasia (CAH), monitoring electrolyte balance is crucial. CAH can lead to adrenal insufficiency, causing imbalances in electrolytes such as sodium and potassium. Monitoring electrolyte levels helps in preventing complications like dehydration, electrolyte disturbances, and adrenal crisis. While blood glucose levels may need monitoring in other conditions like diabetes, it is not the primary concern in CAH. Urine output is important in assessing kidney function but is not a direct monitoring parameter for CAH. Hemoglobin levels are more relevant in conditions such as anemia, not specifically in CAH.

4. What is a primary intervention for a child with a suspected respiratory infection?

• A. Administer antiviral medications
• B. Increase fluid intake and rest
• C. Restrict all physical activity
• D. Provide high-dose vitamin supplements

Correct answer: B

Rationale: Increasing fluid intake and rest is a primary intervention for a child with a suspected respiratory infection because it helps support the body’s recovery and maintains hydration levels. Antiviral medications (Choice A) are only used for specific viral infections and are not routinely recommended for suspected respiratory infections. Restricting physical activity (Choice C) may be necessary in certain cases to prevent overexertion, but it is not a primary intervention. Providing high-dose vitamin supplements (Choice D) may support the immune system in general but is not a primary intervention for a suspected respiratory infection.

5. What is a common sign of a respiratory infection in infants?

• A. Increased appetite
• B. Rapid breathing
• C. Decreased urine output
• D. Lethargy

Correct answer: B

Rationale: Rapid breathing is a common sign of a respiratory infection in infants. When infants have a respiratory infection, their breathing may become rapid as their body tries to get more oxygen. This symptom is often seen alongside cough and fever. Increased appetite (Choice A) is not typically associated with respiratory infections but can be seen in other conditions. Decreased urine output (Choice C) is more indicative of dehydration or kidney issues rather than a respiratory infection. Lethargy (Choice D) can be a symptom of various illnesses but is not as specific to respiratory infections as rapid breathing.

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