Nursing Elites

1. What is the first sign of puberty in boys?

• A. Enlargement of testes
• B. Decreased levels of testosterone
• C. Voice deepening
• D. Pubic hair

Correct answer: A

Rationale: The first sign of puberty in boys is typically the enlargement of the testes. This is due to the increase in production of testosterone, which leads to physical changes such as growth of the testes. Choice B, decreased levels of testosterone, is incorrect as puberty is marked by an increase in testosterone levels. Choice C, voice deepening, and choice D, pubic hair growth, usually occur later in the puberty process compared to testicular enlargement, making them incorrect answers.

2. What should the nurse include in the discharge instructions for the parents of an infant diagnosed with acute otitis media?

• A. Keep the baby in an elevated position during sleep
• B. Administer an antibiotic
• C. Place the baby to sleep with a bottle
• D. Administer acetaminophen (Tylenol) to relieve discomfort

Correct answer: D

Rationale: Acetaminophen (Tylenol) is recommended to help relieve the discomfort associated with acute otitis media, such as pain and fever. Elevating the baby's head during sleep can also help with drainage and relieve pressure, making choice A incorrect. Administering an antibiotic may be necessary for bacterial otitis media but is not usually the first-line treatment for acute otitis media, so choice B is incorrect. Placing the baby to sleep with a bottle can increase the risk of ear infections due to the pooling of milk around the Eustachian tube, so choice C is incorrect.

3. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

• A. Isotonic dehydration
• B. Hypotonic dehydration
• C. Hypertonic dehydration
• D. Hyperosmotic dehydration

Correct answer: B

Rationale: Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.

4. Urinary tract anomalies are frequently associated with what irregularities in fetal development?

• A. Myelomeningocele
• B. Cardiovascular anomalies
• C. Malformed or low-set ears
• D. Defects in lower extremities

Correct answer: C

Rationale: Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.

5. What may be a clinical manifestation of failure to thrive (FTT) in a 13-month-old include?

• A. Irregularity in activities of daily living
• B. Preferring solid food to milk or formula
• C. Weight that is at or below the 10th percentile
• D. Appropriate achievement of developmental landmarks

Correct answer: C

Rationale: FTT is characterized by weight that falls below the 10th percentile, often accompanied by delayed developmental milestones and poor feeding habits. Regularity in activities and preference for solid food over milk or formula are less commonly associated with FTT.

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