Nursing Elites

1. A healthcare provider is assessing the pain level of a three-year-old toddler. Which of the following pain assessment scales should the healthcare provider use?

• A. FACES Pain rating scale
• B. Numeric pain rating scale
• C. CRIES pain assessment scale
• D. Non-communicating children's pain checklist

Correct answer: A

Rationale: The healthcare provider should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts the current level of pain, making it a suitable choice for non-verbal or young children who may have difficulty expressing their pain verbally.

2. The healthcare provider is providing teaching about Social Development to the parents of a preschooler. Which of the following play activities should the provider recommend for the child?

• A. Playing pat-a-cake
• B. Using a push-pull toy
• C. Creating a scrapbook
• D. Playing dress-up

Correct answer: D

Rationale: During the preschool age, play activities should promote social, mental, and physical development. Playing dress-up encourages imagination, creativity, and social interaction, making it an ideal play activity for preschoolers.

3. Which standardized test would be most appropriate for assessing the motor development of a 2-month-old infant in a high-risk clinic?

• A. Peabody Developmental Motor Scale (PDMS-2)
• B. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
• C. Pediatric Evaluation of Disability Index (PEDI)
• D. School Assessment of Motor and Process Skills (School-AMPS)

Correct answer: A

Rationale: The Peabody Developmental Motor Scale (PDMS-2) is specifically designed to assess the motor development of infants and young children, making it the most appropriate choice for evaluating a 2-month-old infant in a high-risk clinic setting.

4. A child receives a vaccine for MMR. Six hours after the injection, the child�s parent reports local soreness, erythema, lethargy, and a fever of 101�F to a nurse. Which action should the nurse take?

• A. Give instructions on relieving symptoms with acetaminophen
• B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
• C. Tell the parent that a live vaccine will cause a mild case of measles
• D. Obtain and fill out a Vaccine Adverse Event Report form

Correct answer: A

Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.

5. An 80-year-old patient with a history of renal insufficiency was recently started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication?

• A. Pain with urination
• B. New onset disorientation to time and place
• C. HR changes from a baseline of 70-80bpm to 110-120bpm
• D. #ERROR!

Correct answer: B

Rationale: The correct answer is B: New onset disorientation to time and place. Cimetidine can cause adverse effects on the CNS system, especially in elderly patients with renal or hepatic impairment. This may manifest as confusion, hallucinations, lethargy, restlessness, or seizures. Pain with urination (choice A) is not typically associated with cimetidine use, and HR changes (choice C) are more likely related to other factors. Choice D is not a valid option.

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