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. What major complication is associated with a child with chronic renal failure?

• A. Hypokalemia
• B. Metabolic alkalosis
• C. Water and sodium retention
• D. Excessive excretion of blood urea nitrogen

Correct answer: C

Rationale: Water and sodium retention is a major complication in chronic renal failure, leading to hypertension and edema. Hypokalemia and metabolic alkalosis are less common, and while BUN levels rise, retention rather than excretion is problematic in chronic renal failure.

3. What interventions would the nurse implement to maintain the skin integrity of a preterm infant born at 30 weeks?

• A. Avoid using alkaline-based soap.
• B. Bathe the infant with sterile water.
• C. Cleanse skin with a gentle alkaline-based soap and water.
• D. Thoroughly rinse skin with plain water after bathing in a mild hexachlorophene solution.

Correct answer: B

Rationale: To maintain the skin integrity of a preterm infant born at 30 weeks, the nurse should bathe the infant with sterile water no more than two or three times per week. The eyes, oral and diaper areas, and pressure points should be cleansed daily. It is essential to avoid using alkaline-based soaps as they might destroy the 'acid mantle' of the skin. Additionally, cleansing with mild solutions and rinsing thoroughly with plain water is recommended to prevent skin irritation and maintain skin integrity. Therefore, options A, C, and D are incorrect as they do not align with the best practices for preterm infant skin care.

4. A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

• A. Stimulate appetite
• B. Detect evidence of edema
• C. Minimize risk of infection
• D. Promote adherence to the antibiotic regimen

Correct answer: C

Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.

5. The predominant characteristic of the intellectual development of a child aged 2 to 7 years is egocentricity. Which of the following best describes this concept?

• A. Selfishness
• B. Unable to see another’s point of view
• C. Able to put self in another’s place
• D. Prefers to play alone

Correct answer: B

Rationale: Egocentricity in children aged 2 to 7 years means they are unable to see things from another person's perspective. This characteristic is a normal part of their cognitive development during this stage. Choice A, 'Selfishness,' is not an accurate description as egocentricity is more about a limited ability to understand others' viewpoints rather than intentional selfishness. Choice C, 'Able to put self in another’s place,' is incorrect as egocentric children struggle to do this. Choice D, 'Prefers to play alone,' is not directly related to egocentricity but may be a behavior exhibited by some children for various reasons.

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