Nursing Elites

1. The Denver II is a test used to assess children. What does it evaluate?

• A. Behavior problems
• B. Developmental status
• C. Body mass index
• D. Infection likelihood

Correct answer: B

Rationale: The Denver II Developmental Screening Test is used to assess a child's development in four areas: personal-social, fine motor-adaptive, language, and gross motor skills. It helps identify children who may need further evaluation. Choice A, behavior problems, is incorrect as the Denver II primarily focuses on developmental milestones rather than behavior. Choice C, body mass index, is unrelated to the assessment of child development. Choice D, infection likelihood, is also not evaluated by the Denver II test.

2. Which pediatric disorder is associated with a 'boot-shaped' heart on a chest x-ray?

• A. Tetralogy of Fallot
• B. Transposition of the great arteries
• C. Coarctation of the aorta
• D. Ventricular septal defect

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot is often associated with a 'boot-shaped' heart appearance on a chest x-ray due to the characteristic heart anatomy in this condition. This appearance is caused by the combination of pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Choice B, Transposition of the great arteries, is incorrect because it presents with a 'egg-on-a-string' appearance on x-ray due to the abnormal position of the aorta and pulmonary artery. Choice C, Coarctation of the aorta, typically presents with rib notching on x-ray. Choice D, Ventricular septal defect, does not produce the 'boot-shaped' heart appearance seen in Tetralogy of Fallot.

3. The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?

• A. Compress the bulb before insertion.
• B. Clear the mouth and pharynx before the nasal passages.
• C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
• D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.

Correct answer: B

Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.

4. A school-age child with cancer is being prepared for a procedure. The child says, “I have had one of these before. They hurt.” The nurse bases her response on what knowledge related to pain in this patient?

• A. Often misrepresent experiencing pain
• B. Tolerate pain better than adults
• C. Become accustomed to painful procedures
• D. Commonly experience treatment-related moderate to severe pain when they have cancer

Correct answer: D

Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.

5. Which responsibilities are included in the pediatric nurse's promotion of the health and well-being of children? (Select all that apply.)

• A. Promoting disease prevention
• B. Providing financial assistance
• C. Providing support and counseling
• D. A, C

Correct answer: D

Rationale: Pediatric nurses promote health through disease prevention, support, counseling, therapeutic relationships, and participating in ethical decision-making.

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