Nursing Elites

1. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

• A. Bowel cleansing
• B. Dietary modification
• C. Structured toilet training
• D. Behavior modification

Correct answer: B

Rationale: Dietary modification is often the first step in managing chronic constipation in children, focusing on increasing fiber and fluid intake. Other interventions like bowel cleansing and toilet training may follow if dietary changes are insufficient.

2. What is the most common cause of bronchiolitis in infants?

• A. Adenovirus
• B. Influenza virus
• C. Respiratory syncytial virus
• D. Parainfluenza virus

Correct answer: C

Rationale: The correct answer is C, Respiratory syncytial virus (RSV). RSV is the leading cause of bronchiolitis, a common respiratory condition in infants that results in inflammation of the small airways in the lung. It is highly contagious and can cause severe respiratory distress in young children, particularly those under 2 years old. Choice A, Adenovirus, is not the most common cause of bronchiolitis in infants. Choice B, Influenza virus, may cause respiratory infections but is not the primary cause of bronchiolitis. Choice D, Parainfluenza virus, can cause croup and other upper respiratory infections but is not the main cause of bronchiolitis in infants.

3. Examination of the abdomen is performed correctly by the nurse in which order?

• A. Inspection, palpation, percussion, and auscultation
• B. Inspection, percussion, auscultation, and palpation
• C. Palpation, percussion, auscultation, and inspection
• D. Inspection, auscultation, percussion, and palpation

Correct answer: D

Rationale: The correct order for abdominal examination is inspection, auscult

4. The LPN is assessing for fontanels on the head of a 6-month-old. Which fontanel is expected to still be present?

• A. Posterior
• B. Anterior
• C. Sphenoid
• D. Lambdoid

Correct answer: B

Rationale: The correct answer is B: Anterior. The anterior fontanel usually remains open until about 12-18 months of age, while the posterior fontanel closes by 2-3 months. Choices A, C, and D are incorrect as the posterior fontanel closes by 2-3 months of age, and the sphenoid and lambdoid fontanels are not typically assessed in routine infant head examinations.

5. The parent asks when the soft area in the infant's head will go away. What is the best response by the nurse?

• A. The area is called the anterior fontanel (fontanelle) and typically closes anytime up to 18 months of age.
• B. The area is called a fontanel (fontanelle). They remain open to allow for rapid brain growth in the first months of life.
• C. The soft spots may stay open until your infant is 2 or 3 years old.
• D. Soft spots on the infant's head should have closed by now.

Correct answer: A

Rationale: The best response by the nurse is A, as the anterior fontanel typically closes between 12-18 months of age, allowing for brain growth during infancy. Choice B is incorrect because it does not provide a specific timeframe for the closure of the fontanel. Choice C is incorrect as it suggests a later closure timeframe than usual. Choice D is incorrect as it states that the soft spots should have closed already, which is inaccurate for a 6-month-old infant.

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