Nursing Elites

1. Which observation of the exposed abdomen is most indicative of pyloric stenosis?

• A. abdominal rigidity
• B. substernal retraction
• C. palpable olive-like mass
• D. marked distention of the lower abdomen

Correct answer: C

Rationale: In pyloric stenosis, a palpable olive-like mass in the abdomen is a classic finding. This mass is due to the hypertrophied pyloric muscle. Abdominal rigidity (choice A) is associated with conditions like peritonitis, substernal retraction (choice B) is typically seen in respiratory distress, and marked distention of the lower abdomen (choice D) is more characteristic of conditions like intestinal obstruction rather than pyloric stenosis.

2. When teaching parents about preventing childhood obesity, what should the nurse recommend?

• A. Encourage high-calorie snacks
• B. Limit screen time
• C. Encourage fast food as a treat
• D. Allow the child to eat freely

Correct answer: B

Rationale: Limiting screen time is a crucial recommendation to prevent childhood obesity. Excessive screen time is associated with sedentary behavior and increased consumption of unhealthy snacks, leading to weight gain. Encouraging high-calorie snacks (Choice A) contradicts the goal of preventing obesity. While fast food as a treat (Choice C) can be consumed occasionally, it should not be encouraged as a regular practice. Allowing the child to eat freely (Choice D) without restrictions can lead to overeating and unhealthy dietary habits, contributing to obesity risk.

3. The healthcare provider is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

• A. abdominal swelling
• B. weight gain
• C. hypotension
• D. increased urinary output

Correct answer: A

Rationale: Abdominal swelling is a classic presentation and often the first noticeable sign of a Wilms tumor. This occurs due to the tumor mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a presenting symptom compared to abdominal swelling. Hypotension (Choice C) is not typically associated with a Wilms tumor unless complications like bleeding or shock occur. Increased urinary output (Choice D) is not a typical finding for Wilms tumor; instead, patients may present with hematuria or urinary symptoms.

4. What is the most common cause of shock (hypoperfusion) in infants and children?

• A. infection
• B. cardiac failure
• C. accidental poisoning
• D. severe allergic reaction

Correct answer: A

Rationale: Infection is the most common cause of shock in infants and children due to their increased susceptibility to sepsis. Infants and children have underdeveloped immune systems, making them more prone to infections that can lead to septic shock. While cardiac failure is a serious condition, it is not the most common cause of shock in this population. Accidental poisoning, though dangerous, is less common than infection in causing shock in infants and children. Severe allergic reactions can lead to anaphylactic shock, but they are not as prevalent as infections in causing shock in this age group.

5. When assessing a child with suspected nephrotic syndrome, what clinical manifestation is the nurse likely to observe?

• A. Jaundice
• B. Edema
• C. Hypertension
• D. Polyuria

Correct answer: B

Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased glomerular permeability leading to the loss of proteins, particularly albumin, in the urine. This results in decreased oncotic pressure, leading to fluid shifting into the interstitial spaces and causing edema. Jaundice (Choice A) is not a typical clinical manifestation of nephrotic syndrome. Hypertension (Choice C) is more commonly associated with conditions like glomerulonephritis. Polyuria (Choice D) is not a primary symptom of nephrotic syndrome; instead, patients may have reduced urine output due to fluid retention from edema.

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