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 is the most common cause of abdominal pain in school-aged children?

• A. Gastroenteritis
• B. Constipation
• C. Appendicitis
• D. Irritable bowel syndrome

Correct answer: B

Rationale: Constipation is the most common cause of abdominal pain in school-aged children. It is often due to dietary factors such as low fiber intake or insufficient fluid consumption. Chronic constipation can lead to complications like fecal impaction and soiling, highlighting the importance of early recognition and treatment. Gastroenteritis, although common, typically presents with diarrhea and vomiting. Appendicitis is more common in adolescents and typically presents with right lower quadrant pain. Irritable bowel syndrome is less common in children and is characterized by recurrent abdominal pain associated with defecation.

3. The nurse is caring for a child with sickle cell anemia with the following order: Morphine Sulfate 2 mg IV every 24 hours. Morphine Sulfate is available in 10 mg/1mL. How many mL should the nurse administer?

• A. 0.2 mL
• B. 0.5 mL
• C. 1 mL
• D. 2 mL

Correct answer: A

Rationale: To administer 2 mg of Morphine Sulfate when the concentration is 10 mg/mL, the nurse should administer 0.2 mL (2 mg / 10 mg/mL = 0.2 mL). Choice B, 0.5 mL, is incorrect because it is the result of dividing 2 mg by 4 mg/mL instead of 10 mg/mL. Choice C, 1 mL, is incorrect as it would be the result of dividing 2 mg by 2 mg/mL. Choice D, 2 mL, is incorrect as it would be the result of dividing 2 mg by 1 mg/mL.

4. The child is admitted to the hospital unit newly diagnosed with retinoblastoma. Which clinical manifestation does the nurse anticipate upon assessment?

• A. A white reflex
• B. Blue-tinged sclerae
• C. A red reflex
• D. Yellow-tinged sclerae

Correct answer: A

Rationale: The correct answer is A: A white reflex. The 'white reflex' or leukocoria is a common sign of retinoblastoma. It occurs when the light reflects off the tumor in the eye, giving the pupil a white appearance instead of the normal red reflex. Blue-tinged sclerae (choice B) and yellow-tinged sclerae (choice D) are not typical manifestations of retinoblastoma. A red reflex (choice C) is the normal reflection seen in the eye when light is shone on it and is not associated with retinoblastoma.

5. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?

• A. After 2 months
• B. After 3 months
• C. After 4 months
• D. After 6 months

Correct answer: D

Rationale: The second dose of the hepatitis A vaccine is recommended 6 months after the first dose to ensure full immunity.

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