Nursing Elites

1. At which age should the nurse expect most infants to begin to say mama and dada with meaning?

• A. 4 months
• B. 6 months
• C. 10 months
• D. 14 months

Correct answer: C

Rationale: By around 10 months, infants often start to say "mama" and "dada" with meaning, associating these words with their parents.

2. The nurse's approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?

• A. The child may think the equipment is alive.
• B. Explaining the equipment will only increase the child’s fear
• C. One brief explanation will be enough to reduce the child’s fear
• D. The child is too young to understand what the equipment does

Correct answer: A

Rationale: Preschoolers may engage in magical thinking and believe inanimate objects are alive, so the nurse should explain the equipment in a way that reduces fear.

3. What is the primary treatment goal for a child with nephrotic syndrome?

• A. Reduce proteinuria
• B. Lower blood pressure
• C. Increase urine output
• D. Prevent infections

Correct answer: A

Rationale: The correct answer is A: Reduce proteinuria. In nephrotic syndrome, the primary treatment goal is to reduce proteinuria to prevent further kidney damage. Lowering blood pressure (choice B) is important in managing some types of kidney disease but is not the primary treatment goal in nephrotic syndrome. Increasing urine output (choice C) and preventing infections (choice D) are important aspects of supportive care but are not the primary treatment goal for nephrotic syndrome.

4. What changes could the school nurse implement at the school to help reduce students’ risk for developing type 2 diabetes?

• A. Increase the amount of daily physical activity.
• B. Decrease the amount of daily physical activity.
• C. Test each child’s urine monthly.
• D. Teach parents to avoid administering aspirin to their child.

Correct answer: A

Rationale: Increasing physical activity helps improve insulin sensitivity and can prevent or delay the onset of type 2 diabetes in children. Regular physical activity is a key component in managing weight and reducing the risk of chronic diseases. Decreasing physical activity (Choice B) would not be beneficial in reducing the risk of type 2 diabetes. Testing each child’s urine monthly (Choice C) is not directly related to preventing type 2 diabetes. Teaching parents to avoid administering aspirin to their child (Choice D) is important for Reye's syndrome prevention but not directly related to reducing the risk of type 2 diabetes.

5. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

• A. Seizure disorder
• B. Narcotic withdrawal
• C. Placental insufficiency
• D. Meconium aspiration syndrome

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

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