Nursing Elites

1. Which assessment data would cause suspicion that a 3-year-old child has Hirschsprung disease?

• A. Clay-colored stools and dark urine
• B. History of early passage of meconium in the newborn period
• C. History of chronic, progressive constipation and failure to gain weight
• D. Continual bouts of foul-smelling diarrhea

Correct answer: C

Rationale: Hirschsprung disease is characterized by chronic, progressive constipation and failure to gain weight. These symptoms are indicative of the disorder due to the absence of ganglion cells in the distal colon, leading to impaired motility and obstruction.

2. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?

• A. Draw a stick figure with seven body parts
• B. Draw a circle
• C. Identify right from left hand
• D. Tie their shoelaces

Correct answer: B

Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.

3. A healthcare professional is reviewing the laboratory results of a child who has nephrotic syndrome. Which of the following findings should the professional expect?

• A. Hypoalbuminemia
• B. Hyperkalemia
• C. Polyuria
• D. Hyperglycemia

Correct answer: A

Rationale: In nephrotic syndrome, there is excessive loss of protein in the urine, leading to hypoalbuminemia. This results in decreased oncotic pressure, causing fluid to shift into the interstitial spaces, leading to edema. Hyperkalemia, polyuria, and hyperglycemia are not typically associated with nephrotic syndrome.

4. What is the probable cause recognized by the nurse when a 5-year-old boy is admitted to the hospital with acute glomerulonephritis?

• A. Recovery from German measles 2 months ago
• B. Dysuria since the previous night
• C. A history of allergy
• D. A sore throat 2 weeks ago

Correct answer: D

Rationale: Acute glomerulonephritis typically develops 1 to 3 weeks after a streptococcal infection, such as a sore throat, which triggers an allergic-type response that affects the glomeruli's function. This immune response leads to inflammation and damage to the glomeruli, resulting in acute glomerulonephritis.

5. When receiving change-of-shift report for children, which child should the nurse assess first?

• A. A toddler who has a concussion and an episode of forceful vomiting
• B. An adolescent with infective endocarditis who reports having a headache
• C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
• D. A school-age child with acute glomerulonephritis and brown-colored urine

Correct answer: A

Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.

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