Nursing Elites

1. During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing?

• A. Separation anxiety.
• B. Associative play.
• C. Object prehension.
• D. Object permanence.

Correct answer: D

Rationale: When a baby looks for a hidden object, it demonstrates the development of object permanence. This milestone is significant as it signifies the baby's understanding that objects continue to exist even when they are not visible. It is a crucial aspect of cognitive development in infancy. Choice A, separation anxiety, refers to distress when separated from a primary caregiver and is not demonstrated in this scenario. Choice B, associative play, involves interactive play with others and is not relevant to object search. Choice C, object prehension, refers to the ability to grasp and hold objects, which is not specifically demonstrated by looking for a hidden object in this context.

2. When developing a behavior modification program for an extremely aggressive 10-year-old boy, what should the nurse do first?

• A. Determine what activities, foods, and toys the child enjoys
• B. Evaluate the child’s previous reactions to punishment
• C. Provide the child with positive feedback
• D. Encourage other children on the unit to describe the token system

Correct answer: A

Rationale: The first step in developing a behavior modification program for an aggressive child is to determine what activities, foods, and toys the child enjoys. Understanding the child's preferences allows the nurse to personalize the program, making it more engaging and effective. This approach increases the chances of success in modifying the aggressive behavior. Evaluating previous reactions to punishment (Choice B) may be important but comes later in the process. Providing positive feedback (Choice C) is beneficial but should come after tailoring the program. Encouraging other children to describe the token system (Choice D) is not the initial step; the focus should be on individualizing the program for the specific child first.

3. When screening a 5-year-old for strabismus, what action should the nurse take?

• A. Have the child identify colored patterns on polychromatic cards.
• B. Direct the child through the six cardinal positions of gaze.
• C. Inspect the child for the setting sun sign.
• D. Observe the child for blank, sunken eyes.

Correct answer: B

Rationale: When screening a 5-year-old for strabismus, directing the child through the six cardinal positions of gaze is the most appropriate action. This method helps the nurse to assess eye alignment, which is crucial in identifying any misalignment that may indicate strabismus. Choices A, C, and D are incorrect. Having the child identify colored patterns on polychromatic cards is more related to visual acuity testing rather than strabismus screening. Inspecting the child for the setting sun sign is not a standard method for strabismus screening. Observing the child for blank, sunken eyes is not specific to strabismus assessment.

4. A child with sickle cell anemia is being treated for a vaso-occlusive crisis. Which intervention should the practical nurse (PN) implement?

• A. Apply cold packs to painful areas.
• B. Encourage increased fluid intake.
• C. Administer high doses of vitamin C.
• D. Provide low-calorie meals.

Correct answer: B

Rationale: Encouraging increased fluid intake is crucial in managing vaso-occlusive crises in patients with sickle cell anemia. Dehydration can worsen these crises, so adequate hydration is essential to prevent complications and improve outcomes. Applying cold packs to painful areas may exacerbate vaso-occlusive crises by causing vasoconstriction. Administering high doses of vitamin C is not directly indicated for vaso-occlusive crises in sickle cell anemia. Providing low-calorie meals is not the priority during a vaso-occlusive crisis; maintaining adequate nutrition is important, but hydration takes precedence in this situation.

5. While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take?

• A. Identify the antibiotics used for treating the pneumonia.
• B. Inquire about the use of alternative treatment methods.
• C. Ask the parents if the child has been in a recent accident.
• D. Report suspected child abuse to the authorities.

Correct answer: B

Rationale: Inquiring about the use of alternative treatment methods is essential to understand cultural practices and provide holistic care. It allows the nurse to gather more information about the blemishes and potentially uncover traditional or alternative healing approaches that the family may have used. This approach demonstrates cultural sensitivity and a comprehensive assessment before making assumptions or taking further actions. Identifying the antibiotics used for treating pneumonia (Choice A) is not immediately necessary in this context as the focus is on the blemishes. Asking about a recent accident (Choice C) assumes a traumatic cause without evidence. Reporting suspected child abuse (Choice D) is premature without further assessment or evidence of abuse.

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