Nursing Elites

1. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

• A. The child may not be pain-free.
• B. The parents or nurse may push the button for a bolus if needed.
• C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
• D. Monitoring is required every 1 to 2 hours to assess patient response.

Correct answer: C

Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.

2. Which family theory is described as a series of tasks for the family throughout its life span?

• A. Exchange theory
• B. Developmental theory
• C. Structural-functional theory
• D. Symbolic interactional theory

Correct answer: B

Rationale: Developmental theory outlines the series of tasks and stages that a family goes through over its life span, helping to understand the family's development and needs over time.

3. The nurse is caring for a child with Neuroblastoma. Where is the tumor most commonly located?

• A. Bone
• B. Kidneys
• C. Cortex
• D. Abdomen

Correct answer: D

Rationale: Neuroblastoma is a cancer that commonly originates in the adrenal glands located in the abdomen. It can also occur in nerve tissues along the spine, but it is most frequently found in the abdominal region. Therefore, the correct answer is D. Choices A, B, and C are incorrect as Neuroblastoma typically arises from neural crest cells in the adrenal glands or sympathetic ganglia, not in the bones, kidneys, or cortex.

4. 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.

5. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?

• A. A normal finding
• B. A sign of a possible visual defect and a need for vision screening
• C. An abnormal finding requiring referral to an ophthalmologist
• D. A sign of small hemorrhages, which usually resolve spontaneously

Correct answer: A

Rationale: A brilliant, uniform red reflex in both eyes is a normal finding, indicating that the retina is healthy and there are no significant obstructions in the visual pathway.

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