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. What is the therapeutic intervention that provides the best chance of survival for a child with cirrhosis?

• A. Nutritional support
• B. Liver transplantation
• C. Blood component therapy
• D. Treatment with corticosteroids

Correct answer: B

Rationale: Liver transplantation offers the best chance of survival for children with cirrhosis, especially in advanced stages where the liver can no longer function effectively. Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. While nutritional support, blood component therapy, and corticosteroids may be part of the treatment plan to manage symptoms and complications, they do not address the underlying cause of cirrhosis or provide a cure like liver transplantation does.

3. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?

• A. Interactional theory
• B. Family stress theory
• C. Erikson's psychosocial theory
• D. Developmental systems theory

Correct answer: B

Rationale: Family stress theory explains how families respond to stress and identifies factors that help families adapt to and manage stressful events effectively.

4. Which is considered a block to effective communication?

• A. Using silence
• B. Using clichés
• C. Directing the focus
• D. Defining the problem

Correct answer: B

Rationale: Using clichés is a communication block because it can come across as dismissive or insincere, hindering meaningful dialogue.

5. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

• A. 50th percentile
• B. 75th percentile
• C. 80th percentile
• D. 95th percentile

Correct answer: D

Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.

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