Nursing Elites

1. Which condition is characterized by a "barking" cough in children?

• A. Asthma
• B. Bronchiolitis
• C. Croup
• D. Pneumonia

Correct answer: C

Rationale: Croup is the correct answer. It is characterized by a distinctive "barking" cough, typically worse at night, caused by the inflammation of the upper airway, specifically the larynx and trachea. Asthma (Choice A) typically presents with wheezing and shortness of breath rather than a barking cough. Bronchiolitis (Choice B) commonly causes wheezing and respiratory distress in infants and young children. Pneumonia (Choice D) often presents with symptoms like fever, productive cough, and chest pain, but not typically a barking cough.

2. Which are included in the evaluation step of the nursing process? (Select all that apply.)

• A. All below
• B. Ascertaining if the plan requires modification
• C. Determination if the outcome has been met
• D. Selecting alternative interventions if the outcome has not been met

Correct answer: A

Rationale: The evaluation step involves determining if outcomes are met, modifying the plan if needed, and selecting alternative interventions if goals are not achieved.

3. Which finding suggests fluid volume deficit in an infant presenting with vomiting and diarrhea for 2 days?

• A. Increased blood pressure
• B. A sunken fontanel
• C. Decreased pulse rate
• D. Low urine specific gravity

Correct answer: B

Rationale: A sunken fontanel is a classic sign of dehydration in infants, indicating a fluid volume deficit. In dehydration, the fontanel sinks due to decreased fluid volume in the body. Increased blood pressure (Choice A) is not typically associated with dehydration in infants. Decreased pulse rate (Choice C) is not a common finding in fluid volume deficit, as the body tries to increase the heart rate to compensate for decreased volume. Low urine specific gravity (Choice D) may be seen in dehydration, but it is not as specific or as easily observable as a sunken fontanel.

4. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

• A. Seizure disorder
• B. Narcotic withdrawal
• C. Placental insufficiency
• D. Meconium aspiration syndrome

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

5. Which is the most frequently used test for measuring visual acuity?

• A. Snellen letter chart
• B. Ishihara vision test
• C. Allen picture card test
• D. Denver eye screening test

Correct answer: A

Rationale: The Snellen letter chart is the most commonly used test for measuring visual acuity, particularly in school-age children and adults.

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