Nursing Elites

1. At a well-visit, a mother voices concern that her 30-month-old has a smaller vocabulary than other children in his daycare. The nurse should:

• A. Admit the child to the hospital
• B. Assess the child for other age-appropriate development
• C. Suggest that the child is hearing impaired
• D. Explain that the child has a significant developmental delay

Correct answer: B

Rationale: When a parent expresses concern about a child's development, it is essential to conduct a comprehensive assessment of all areas of development before jumping to conclusions. Choosing option B allows the nurse to evaluate the child for other age-appropriate developmental milestones to determine if there are any delays or concerns. Admitting the child to the hospital (option A) is not necessary at this point and may cause unnecessary stress. Suggesting hearing impairment (option C) without proper evaluation can lead to misdiagnosis. Explaining a significant developmental delay (option D) should only be done after a thorough assessment and diagnosis.

2. Which immunization is recommended for all newborns?

• A. Hepatitis A vaccine
• B. Hepatitis B vaccine
• C. Hepatitis C vaccine
• D. Hepatitis A, B, and C vaccines

Correct answer: B

Rationale: The correct answer is B, the Hepatitis B vaccine. This vaccine is recommended for all newborns to prevent Hepatitis B infection, which can lead to chronic liver disease and liver cancer. The Hepatitis B vaccine is a crucial part of the routine immunization schedule for infants. Choices A, C, and D are incorrect because the recommended vaccine for newborns is specifically Hepatitis B, not Hepatitis A, Hepatitis C, or a combination of Hepatitis A, B, and C vaccines.

3. A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?

• A. Reassure the father that Visine is harmless.
• B. Direct him to seek immediate medical treatment.
• C. Recommend inducing vomiting with ipecac.
• D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.

Correct answer: B

Rationale: Visine is not harmless when ingested, and immediate medical treatment is necessary due to the risk of toxicity. Vomiting should not be induced without medical advice, and dilution with water is not an appropriate treatment.

4. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?

• A. Gastrointestinal perforation may have occurred.
• B. The object may have been aspirated.
• C. The object may be lodged in the esophagus.
• D. The object may be embedded in the stomach wall.

Correct answer: C

Rationale: The symptoms of gagging and drooling suggest that the foreign object is likely lodged in the esophagus. This can cause significant discomfort and potential complications, requiring immediate medical evaluation.

5. What is the most common cause of acute kidney injury in children?

• A. Dehydration
• B. Glomerulonephritis
• C. Hemolytic uremic syndrome
• D. Sepsis

Correct answer: C

Rationale: Hemolytic uremic syndrome is the most common cause of acute kidney injury in children. While dehydration can lead to prerenal acute kidney injury, it is not the most common cause in children. Glomerulonephritis is a common cause of chronic kidney disease but not typically the most common cause of acute kidney injury in children. Sepsis can lead to acute kidney injury, but in children, hemolytic uremic syndrome is more prevalent.

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