Nursing Elites

1. Which factor is most likely to cause a "brittle" diabetic state in a child with type 1 diabetes?

• A. Noncompliance with diet
• B. Insulin resistance
• C. Frequent infections
• D. Hypothyroidism

Correct answer: C

Rationale: Frequent infections can destabilize blood sugar levels, leading to a "brittle" diabetic state in children with type 1 diabetes. Infections increase metabolic demands and can result in significant blood glucose fluctuations, requiring careful monitoring and adjustment of insulin therapy. Noncompliance with diet may affect blood sugar control but is not the primary cause of a "brittle" state. Insulin resistance is more common in type 2 diabetes rather than type 1. Hypothyroidism can impact metabolism but is not directly linked to the development of a "brittle" diabetic state in type 1 diabetes.

2. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

• A. Female, multiple siblings, stable home life
• B. Male, high activity level, stressful home life
• C. Male, even-tempered, history of previous injuries
• D. Female, reacts negatively to new situations, no serious previous injuries

Correct answer: B

Rationale: A male child with a high activity level and a stressful home life has multiple risk factors for childhood injuries, requiring closer supervision and preventive measures.

3. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?

• A. Acute diarrhea and dehydration
• B. Current jelly-like stools and pain
• C. Failure to pass meconium and abdominal distension
• D. Projectile vomiting and altered electrolytes

Correct answer: C

Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.

4. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?

• A. Identity vs. role diffusion
• B. Trust vs. mistrust
• C. Industry vs. inferiority
• D. Autonomy vs. shame and doubt

Correct answer: A

Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.

5. What is the best age to introduce solid food into an infant’s diet?

• A. 2 to 3 months
• B. 4 to 6 months
• C. When birth weight has tripled
• D. When tooth eruption has started

Correct answer: B

Rationale: The introduction of solid foods is recommended at 4 to 6 months when the infant's digestive system is more developed and ready for solids.

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