Nursing Elites

1. At what stage can infants raise their heads and gain control of their trunks before walking due to which directional pattern of development?

• A. Cephalocaudal
• B. Anterior to posterior
• C. Proximodistal
• D. Normal growth curve charts

Correct answer: A

Rationale: The correct answer is A: Cephalocaudal. The cephalocaudal pattern of development means that growth and motor control proceed from the head downward through the body. This explains why infants can raise their heads before they can sit and gain control of their trunks before walking. Choices B, C, and D are incorrect. Anterior to posterior refers to development from the front to the back, while proximodistal refers to development from the center of the body outward. Normal growth curve charts are used to track physical growth over time and are not directly related to the directional pattern of development in infants.

2. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?

• A. Rinne test
• B. Weber test
• C. Pure tone audiometry
• D. Eliciting the startle reflex

Correct answer: C

Rationale: Pure tone audiometry is an appropriate and effective screening test for hearing in a 5-year-old child, helping to assess the ability to hear various frequencies and volumes.

3. Physiologically, the child compensates for fluid volume losses by which mechanism?

• A. Inhibition of aldosterone secretion
• B. Hemoconcentration to reduce cardiac workload
• C. Fluid shift from interstitial space to intravascular space
• D. Vasodilation of peripheral arterioles to increase perfusion

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

4. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?

• A. An emergency laparotomy is very likely.
• B. The location needs to be confirmed by radiographic examination.
• C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
• D. Careful observation is essential because an ingested battery cannot be accurately detected.

Correct answer: B

Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.

5. The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?

• A. Help the toddler complete tasks
• B. Encourage the toddler to do things for themselves when capable
• C. Provide opportunities for the toddler to play with other children
• D. Help the toddler learn the difference between right and wrong

Correct answer: B

Rationale: Encouraging the toddler to do things for themselves when capable is the correct intervention to foster autonomy. This approach helps the toddler develop independence, self-confidence, and a sense of achievement. Choice A is incorrect as it focuses on assisting rather than encouraging independence. Choice C is incorrect as playing with other children primarily fosters social skills, not necessarily autonomy. Choice D is incorrect as learning the difference between right and wrong is related to moral development, not autonomy.

Similar Questions