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. In counseling the parents of a child with hypopituitarism, Nurse Gyimah is asked about their child's condition. Which of the following phrases, if stated by the nurse, best describes the condition?

• A. Linear growth retardation with skeletal proportions normal for chronologic age
• B. A complete normal growth pattern, but with the onset of precocious puberty
• C. Normal growth for the first five years, followed by progressive linear growth retardation
• D. Growth retardation in which height and weight are equally affected

Correct answer: A

Rationale: Hypopituitarism is characterized by linear growth retardation with skeletal proportions normal for chronologic age. This means that although the child experiences growth retardation, their skeletal proportions are appropriate for their age, which distinguishes it from other conditions like precocious puberty or equal height and weight affectation. Choice B is incorrect as hypopituitarism does not involve precocious puberty. Choice C is wrong as it describes a different growth pattern not typical of hypopituitarism. Choice D is also incorrect as in hypopituitarism, height and weight are not equally affected, rather the focus is on linear growth retardation with normal skeletal proportions.

3. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

4. What is the purpose of the pediatric assessment triangle?

• A. Detect immediate life threats through a quick hands-on assessment.
• B. Identify if the child has a medical condition or a traumatic injury.
• C. Determine if the child's problem is respiratory or circulatory in nature.
• D. Form a general impression of the child without touching them.

Correct answer: D

Rationale: The pediatric assessment triangle is used to form a rapid, hands-off general impression of the child's condition without directly touching them. This visual assessment helps in identifying children who require immediate attention and further evaluation.

5. Which of the following injuries is MOST indicative of child abuse?

• A. Multiple bruises to the shins
• B. Burned hand with splash marks
• C. Small laceration to the chin
• D. Bruising to the upper back

Correct answer: D

Rationale: Bruising to the upper back is more suspicious for child abuse compared to the other listed injuries. In young children, injuries like bruises to the upper back are less likely to be accidental and may raise concerns about physical abuse. The upper back is an area less prone to accidental injuries during play or falls. Multiple bruises to the shins are common in active children. A burned hand with splash marks may suggest accidental burns. A small laceration to the chin is also a common injury from falls in children. Therefore, the bruising on the upper back is more concerning for possible child abuse.

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