Nursing Elites

1. A young mother asks if her 9-month-old can begin drinking cow’s milk instead of formula. You explain that:

• A. Cow’s milk is easier to digest than formula
• B. Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year
• C. As long as whole milk is given and not skim milk, it is okay
• D. Cow’s milk will decrease the chance of iron deficiency anemia

Correct answer: B

Rationale: Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year. Cow’s milk is not suitable for infants under 1 year of age as it lacks essential nutrients like iron and can lead to iron deficiency. Therefore, it is important to continue with breast milk or formula to ensure the baby's nutritional needs are met. Choice A is incorrect as cow’s milk is not easier to digest than formula for infants. Choice C is incorrect as the type of milk, whether whole or skim, is not the primary concern at this age. Choice D is incorrect as cow’s milk can actually increase the risk of iron deficiency anemia in infants.

2. Why is it difficult to assess a child’s dietary intake?

• A. No systematic assessment tool has been developed
• B. Biochemical analysis for assessing nutrition is expensive
• C. Families usually do not understand much about nutrition
• D. Recall of food consumption is frequently unreliable

Correct answer: D

Rationale: The correct answer is D. Recall of food intake, especially amounts eaten, is often unreliable. While systematic tools like the 24-hour recall and dietary history questionnaires exist, recall can still be challenging in accurately assessing a child's dietary intake. Choices A, B, and C are incorrect because systematic assessment tools do exist, biochemical analysis is not the primary method for dietary assessment, and families' understanding of nutrition may vary but is not the main reason for the difficulty in assessing a child's dietary intake.

3. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?

• A. Indicative of maladjustment
• B. A common reaction to divorce
• C. Suggestive of a lack of adequate parenting
• D. An unusual response that indicates a need for referral

Correct answer: B

Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.

4. Which is the leading cause of death in infants younger than 1 year in the United States?

• A. Congenital anomalies
• B. Sudden infant death syndrome
• C. Disorders related to short gestation and low birth weight
• D. Maternal complications specific to the perinatal period

Correct answer: A

Rationale: Congenital anomalies are the leading cause of death in infants younger than 1 year in the United States.

5. You are developing a plan of care for a hospitalized child. Which age group is most likely to view illness as a punishment for misdeeds?

• A. Adolescence
• B. Preschool age
• C. Infancy
• D. School age

Correct answer: B

Rationale: Preschool-aged children often engage in magical thinking, where they may believe that illness is a punishment for misdeeds. This belief is related to their cognitive development stage, where they may attribute cause and effect in a magical or unrealistic way. Adolescents are more likely to view illness as a disruption to their sense of independence or control. Infants lack the cognitive development to associate illness with punishment for misdeeds. School-aged children typically have a more concrete understanding of illness and its causes, moving away from magical thinking.

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