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. A mother delivers an infant at 30 weeks gestation and asks if formula is better than breast milk since the baby is premature. What should the nurse respond?

• A. Human milk is preferred over other types of nutrition
• B. Human milk lacks essential nutrients for preterm infants
• C. Commercial infant formulas are preferred for preterm infants
• D. Commercial formulas have not been designed to meet preterm infants' needs

Correct answer: A

Rationale: Human milk is preferred, even for preterm infants, because it contains essential nutrients and antibodies that are particularly beneficial for their growth and development. Choice B is incorrect because human milk is rich in essential nutrients necessary for preterm infants. Choice C is incorrect as commercial infant formulas do not provide the same benefits as human milk. Choice D is incorrect as specialized formulas are available to meet the unique nutritional needs of preterm infants, but human milk remains the optimal choice.

3. The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)

• A. Encourage fluids.
• B. Monitor urinary output.
• C. Monitor sodium serum levels.
• D. All above

Correct answer: D

Rationale: Gentamicin is an aminoglycoside antibiotic that requires monitoring of serum peak and trough levels to avoid toxicity, particularly nephrotoxicity and ototoxicity. Encouraging fluids and monitoring urinary output are also crucial to minimize the risk of kidney damage.

4. The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?

• A. Place the child in the Trendelenburg position.
• B. Apply moist heat to the abdomen.
• C. Allow the child to assume a position of comfort.
• D. Administer a saline enema to cleanse the bowel.

Correct answer: C

Rationale: Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.

5. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?

• A. Suicide and cancer
• B. Suicide and homicide
• C. Drowning and cancer
• D. Homicide and heart disease

Correct answer: B

Rationale: Suicide and homicide are significant causes of death in adolescents, highlighting the need for mental health and violence prevention programs.

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