Nursing Elites

1. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?

• A. Ethnicity
• B. Racial variation
• C. Status
• D. Geographic boundaries

Correct answer: C

Rationale: Status, or the social standing within a culture, is often culturally determined and plays a significant role in shaping behaviors and expectations.

2. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

• A. At the lacrimal duct
• B. On the sclera while the child looks to the outside
• C. In the conjunctival sac when the lower eyelid is pulled down
• D. Carefully under the eyelid while it is gently pulled upward

Correct answer: C

Rationale: Eye drops should be placed in the conjunctival sac, which allows the medication to be absorbed properly without causing irritation. Placing drops directly on the sclera or near the lacrimal duct is less effective and can cause discomfort.

3. According to Freud’s developmental theory, infancy is a stage of:

• A. Orality
• B. Latency
• C. Genitality
• D. Anality

Correct answer: A

Rationale: In Freud’s psychosexual development theory, the oral stage is the first stage and occurs during infancy. It focuses on activities involving the mouth, such as sucking and feeding. This stage is crucial for the child's development as it forms the basis for trust and attachment. Choices B, C, and D are incorrect as latency refers to the stage during middle childhood where sexual impulses are suppressed, genitality refers to the final stage focusing on mature sexual relationships, and anality refers to the stage occurring during the toddler years where toilet training plays a significant role.

4. What findings on physical assessment of a neonate would indicate the need for further evaluation?

• A. Nystagmus
• B. Epstein pearls
• C. Low-set ears
• D. Positive Babinski reflex

Correct answer: C

Rationale: Low-set ears in a neonate suggest major abnormalities and should prompt further evaluation. The correct alignment of the top of the pinnae of the ear with the outer canthus of the eye is crucial. Nystagmus, an involuntary eye movement, is common in newborns and often resolves on its own. Epstein pearls, small cysts on the hard palate, are insignificant and disappear over time. A positive Babinski reflex is normal in infants up to 1 year of age. Therefore, the presence of low-set ears is the most concerning finding that requires immediate attention.

5. Which pediatric condition is most likely to present with a "whooping" sound during coughing?

• A. Croup
• B. Bronchitis
• C. Pertussis
• D. Asthma

Correct answer: C

Rationale: The correct answer is C: Pertussis. Pertussis, also known as whooping cough, is characterized by a "whooping" sound during coughing episodes. This distinctive sound is due to the rapid intake of air after a series of coughs. Choice A, Croup, typically presents with a barking cough and stridor. Choice B, Bronchitis, is characterized by a productive cough with mucus. Choice D, Asthma, usually presents with wheezing and shortness of breath.

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