Nursing Elites

1. Which sign is indicative of developmental dysplasia of the hip in infants?

• A. Ortolani sign
• B. Romberg sign
• C. Trendelenburg sign
• D. Gower's sign

Correct answer: A

Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.

2. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

• A. Codeine sulfate (Codeine)
• B. Morphine (Roxanol)
• C. Methadone (Dolophine)
• D. Meperidine (Demerol)

Correct answer: B

Rationale: Morphine is the drug of choice for PCA in children because of its efficacy, safety profile, and rapid onset of action for pain management.

3. When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

• A. Anorexia
• B. Bradycardia
• C. Sudden relief from pain
• D. Decreased abdominal distention

Correct answer: C

Rationale: When caring for a child with probable appendicitis, sudden relief from pain is a critical sign that could indicate perforation of the appendix. Perforation results in the release of pressure and inflammation, leading to a temporary relief of pain. Anorexia (loss of appetite) and decreased abdominal distention are symptoms commonly associated with appendicitis itself, not perforation. Bradycardia (slow heart rate) is not typically a direct manifestation of appendicitis or its complications.

4. What is the required number of milliliters of fluid needed per day for a 14-kg child?

• A. 800
• B. 1000
• C. 1200
• D. 1400

Correct answer: D

Rationale: The fluid requirement for a 14-kg child is approximately 100 mL/kg/day, so for a 14-kg child, the requirement is around 1400 mL/day.

5. What is the most consistent and commonly used indicator of pain in infants?

• A. Increased respirations
• B. Increased heart rate
• C. Thrashing of arms and legs
• D. Facial expression of discomfort

Correct answer: D

Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.

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