Nursing Elites

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

• A. Acne
• B. Hair growth in the pubic area and underarms
• C. Thelarche
• D. Menarche

Correct answer: C

Rationale: The correct answer is C, Thelarche. Thelarche refers to the onset of breast development, which is typically the first sign of puberty in girls. This occurs before menarche (the first menstrual period). Choices A and B, acne and hair growth in the pubic area and underarms, are not the first signs of puberty in girls. While acne can be a common occurrence during puberty, it usually appears after other physical changes. Hair growth in the pubic area and underarms also occurs later in the puberty process.

2. A child with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention should be included in the plan of care?

• A. Monitor blood pressure every 30 minutes.
• B. Reposition the child every two hours.
• C. Limit visitors.
• D. Encourage fluids.

Correct answer: B

Rationale: Repositioning the child every two hours is essential to prevent pressure ulcers and promote circulation, especially when the child is on bed rest and experiencing severe edema. Monitoring blood pressure is important but does not need to be done every 30 minutes unless indicated. Limiting visitors and encouraging fluids are not directly related to managing edema and preventing complications from immobility. Therefore, choice B is the most appropriate nursing intervention in this scenario.

3. The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?

• A. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel
• B. I can use a music box and soft mobiles as appropriate play activities for my baby
• C. I should introduce a cup and spoon or push-pull toys for my baby at this age
• D. I do not have to worry about appropriate play activities at this age

Correct answer: B

Rationale: At 2 months, infants are most stimulated by visual and auditory activities, such as a music box or soft mobiles. These activities help in sensory development and are appropriate for this age.

4. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

• A. Chromosome analysis will be complete in 7 days.
• B. A physical examination will be able to provide a definitive answer.
• C. Additional laboratory testing is necessary to assign the correct gender.
• D. Gender assignment involves collaboration between the parents and a multidisciplinary team.

Correct answer: D

Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.

5. A 12-month-old infant has been diagnosed with failure to thrive (FTT). Which assessment findings does the nurse expect to be documented with this infant?

• A. Fear of strangers
• B. Minimal smiling
• C. Avoidance of eye contact
• D. All of the above

Correct answer: D

Rationale: These behaviors are consistent with FTT and indicate social withdrawal, which is often observed in infants who are not thriving. A wide-eyed gaze and avoidance of eye contact can also indicate developmental delays or emotional disturbances.

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