Nursing Elites

1. As children grow and develop, their style of play changes. Which play style is descriptive of the school-age child?

• A. Plays alone but not with other children
• B. Plays games with other children and is able to follow the rules of the game
• C. Plays alone with play directed by others
• D. Plays with others in loose groups

Correct answer: B

Rationale: The correct answer is B. School-age children are typically able to play structured games with other children and follow the rules of the game. This ability reflects their growing cognitive and social development. Choice A is incorrect as school-age children often engage in group play. Choice C is incorrect as school-age children usually have more autonomy in their play choices. Choice D is incorrect as school-age children tend to form more organized play settings rather than loose groups.

2. What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?

• A. Hold feedings.
• B. Check gastric residuals before feedings.
• C. Take rectal temperature.
• D. Closely monitor abdominal distention.

Correct answer: D

Rationale: The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.

3. Which is a complication that can occur after abdominal surgery if pain is not managed?

• A. Atelectasis
• B. Hypoglycemia
• C. Decrease in heart rate
• D. Increase in cardiac output

Correct answer: A

Rationale: Poorly managed pain after abdominal surgery can lead to complications like atelectasis due to shallow breathing, which may occur if the child avoids deep breaths because of pain.

4. A 12-year-old girl has recently begun menstruating and is well into puberty. The child is visiting the health care provider today for a routine physical examination. Which finding should cause concern in the nurse?

• A. Breasts of slightly different sizes
• B. Irregular periods
• C. Vulvar irritation
• D. Supernumerary nipple

Correct answer: C

Rationale: Vulvar irritation may indicate an infection or other issues and should be further evaluated. In a pubescent girl, breasts of slightly different sizes and irregular periods are common variations of normal development. Supernumerary nipple, an extra nipple, is a benign condition that is not typically concerning during puberty.

5. By what age does birth weight usually triple?

• A. 1 year
• B. 1 month
• C. 2 years
• D. 6 months

Correct answer: A

Rationale: The correct answer is A: 1 year. By the age of 1 year, a baby’s birth weight typically triples. This period allows for significant growth and development in infants. Choices B, C, and D are incorrect because birth weight does not usually triple by 1 month, 2 years, or 6 months of age, respectively.

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