Nursing Elites

1. What characteristic indicates that a mass on a newborn's head is a cephalohematoma?

• A. The mass appears on the second day after birth.
• B. The mass grows larger when the newborn cries.
• C. The head appears asymmetrical.
• D. The mass is located on only one side of the head.

Correct answer: A

Rationale: A cephalohematoma typically appears between the first and second days after birth, making choice A the correct answer. It results from blood vessel rupture between a cranial bone and the periosteal membrane. Choices B, C, and D are incorrect because the growth of the mass when the newborn cries, asymmetrical head appearance, or the mass being located on only one side of the head are not specific indicators of a cephalohematoma.

2. A 3-month-old is hospitalized with a fractured femur. The pain assessment tool most appropriate for this child is the:

• A. FLACC scale.
• B. Poker chip tool.
• C. Number scale.
• D. Visual analog scale.

Correct answer: A

Rationale: The FLACC scale is a validated pain assessment tool suitable for infants and young children, including 3-month-olds. It assesses pain based on five categories: Face, Legs, Activity, Cry, and Consolability. Since infants cannot communicate their pain verbally, the FLACC scale is effective in evaluating pain by observing these behavioral indicators. The other options, such as the Poker chip tool, Number scale, and Visual analog scale, are not specifically designed for infants and may not provide accurate pain assessment in this age group.

3. A postpartum client is concerned about hair loss. The nurse explains that this is:

• A. A sign of nutritional deficiency
• B. A temporary condition due to hormonal changes
• C. An indication of a thyroid disorder
• D. A result of poor hair care during pregnancy

Correct answer: B

Rationale: Hair loss postpartum is a common temporary condition caused by hormonal changes that occur after giving birth. This condition is known as postpartum alopecia and is a normal part of the postpartum period. It is important for the nurse to reassure the client that this hair loss is temporary and usually resolves on its own without the need for medical intervention. Choice A is incorrect because postpartum hair loss is primarily due to hormonal changes rather than nutritional deficiency. Choice C is incorrect as thyroid disorder is not typically the cause of postpartum hair loss. Choice D is incorrect as poor hair care during pregnancy does not cause postpartum hair loss.

4. What advice should a school-age child with type 1 diabetes mellitus follow to prevent hypoglycemia during soccer practice?

• A. Drink a cup of orange juice before soccer practice
• B. Eat twice the amount normally eaten at lunchtime
• C. Take half the amount of prescribed insulin on practice days
• D. Take the prescribed insulin at noontime rather than in the morning

Correct answer: A

Rationale: Drinking orange juice before soccer practice is recommended to prevent hypoglycemia in children with type 1 diabetes. Orange juice contains fast-acting carbohydrates that can quickly raise blood sugar levels if they drop during physical activity. Eating twice the amount normally eaten at lunchtime can lead to hyperglycemia, which is high blood sugar, rather than preventing hypoglycemia. Adjusting insulin doses should only be done under the guidance of a healthcare provider. Taking insulin at noontime rather than in the morning does not directly address preventing hypoglycemia during afternoon soccer practice.

5. What is the proper depth of chest compressions for a 9-month-old infant?

• A. 1/3 the diameter of the chest or about 1 1/2 inches.
• B. 1/4 the diameter of the chest or about 1 inch.
• C. 1/2 the diameter of the chest or about 2 inches.
• D. 1/3 the diameter of the chest or about 3/4 inch.

Correct answer: A

Rationale: When performing chest compressions on a 9-month-old infant, the proper depth is 1/3 the diameter of the chest, which equates to approximately 1 1/2 inches. This depth is crucial for effective cardiopulmonary resuscitation (CPR) in infants. Choice B, which suggests 1/4 the diameter of the chest or about 1 inch, is incorrect as it does not provide the recommended depth for infants. Choice C, stating 1/2 the diameter of the chest or about 2 inches, is too deep and may cause harm to the infant. Choice D, mentioning 1/3 the diameter of the chest or about 3/4 inch, is also incorrect as it underestimates the required depth for effective chest compressions on a 9-month-old infant.

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