Nursing Elites

1. A preschooler pretending to do the dishes like her mother is an example of:

• A. Domestic mimicry
• B. Artificialism
• C. Magical thinking
• D. Centering

Correct answer: A

Rationale: Domestic mimicry is the correct answer. It refers to children imitating household activities they observe, aiding in their cognitive and social development. By engaging in such play, children understand and interact with the world around them. Choice B, 'Artificialism,' is incorrect as it pertains to the belief that environmental characteristics are created by human beings. Choice C, 'Magical thinking,' involves children believing in unrealistic events or powers. Choice D, 'Centering,' refers to a child focusing on only one aspect of a situation and not considering other viewpoints.

2. What findings on physical assessment of a neonate would indicate the need for further evaluation?

• A. Nystagmus
• B. Epstein pearls
• C. Low-set ears
• D. Positive Babinski reflex

Correct answer: C

Rationale: Low-set ears in a neonate suggest major abnormalities and should prompt further evaluation. The correct alignment of the top of the pinnae of the ear with the outer canthus of the eye is crucial. Nystagmus, an involuntary eye movement, is common in newborns and often resolves on its own. Epstein pearls, small cysts on the hard palate, are insignificant and disappear over time. A positive Babinski reflex is normal in infants up to 1 year of age. Therefore, the presence of low-set ears is the most concerning finding that requires immediate attention.

3. A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?

• A. Refer him for immediate medical evaluation
• B. Administer analgesics and recommend scrotal support.
• C. Apply an ice bag and observe for increasing pain.
• D. Reassure the adolescent that occasional pain is common with the changes of puberty.

Correct answer: A

Rationale: Sudden and severe scrotal pain in an adolescent male is a medical emergency and may indicate testicular torsion, which requires immediate evaluation and intervention to prevent testicular loss.

4. A mother delivers an infant at 30 weeks gestation. The mother asks the nurse for information on nutrition and if formula would be better since the baby is premature. What is the foundation for the response to the mother by the nurse?

• A. Human milk is preferred over other types of nutrition.
• B. Human milk lacks essential nutrients when the infant is preterm.
• C. Commercial infant formulas are preferred over other types of nutrition.
• D. Commercial infant formulas have not been designed to meet the nutritional needs of preterm infants.

Correct answer: A

Rationale: The correct answer is A. Human milk is the preferred food for infants, including preterm infants. It contains essential ingredients necessary for the infant's growth and development. The mother should pump her breasts to provide milk for the infant if the child is receiving enteral feedings. Once the infant can coordinate breathing, sucking, and swallowing, breastfeeding directly is encouraged. Studies have shown that preterm infants fed fortified human milk have better outcomes compared to those fed commercial infant formulas. Commercial infant formulas may not fully meet the unique nutritional needs of preterm infants, leading to potential longer hospital stays. Therefore, human milk is the best choice for feeding premature infants.

5. The nurse understands that blocks to therapeutic communication include what? (Select all that apply.)

• A. Socializing
• B. All are applicable
• C. Using clichés
• D. Defending a situation

Correct answer: B

Rationale: Socializing, using clichés, and defending a situation are all barriers to effective therapeutic communication. Silence is a useful tool in therapeutic communication.

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