Nursing Elites

1. The mother of an 11-year-old girl confides to the nurse that her child has no interest in school activities, exercise, or even family outings. The most appropriate response by the nurse would be:

• A. I would recommend that she see a counselor at school.
• B. I would not worry; she will grow out of it.
• C. Many girls this age go through a time of malaise and disinterest.
• D. If she still feels the same way when you come back for the next well-child visit, I will recommend a therapist.

Correct answer: A

Rationale: When a child shows a lack of interest in various activities, including school, exercise, and family outings, it is essential to address the underlying reasons. Recommending that the child see a counselor at school is crucial to explore potential issues and provide appropriate support and guidance. This approach can help identify any emotional, social, or behavioral concerns the child may be experiencing and facilitate early intervention and support. Choice B is incorrect because dismissing the mother's concerns and assuming the child will grow out of it without addressing the issue is not appropriate. Choice C is incorrect because while some children may go through phases of disinterest, it is essential to investigate further rather than generalizing. Choice D is incorrect because waiting until the next visit without taking proactive steps to address the current lack of interest may delay necessary support and intervention.

2. The caregiver is teaching a new mother about infant safety. Which statement indicates that further teaching is needed?

• A. I will place my baby on their back to sleep.
• B. I will keep soft toys and pillows out of the crib.
• C. I will use a car seat for every car ride.
• D. I will allow my baby to sleep in my bed.

Correct answer: D

Rationale: Allowing a baby to sleep in an adult bed increases the risk of suffocation and Sudden Infant Death Syndrome (SIDS). It is safer for infants to sleep on a firm, flat surface in their own crib or bassinet to reduce the risk of accidental suffocation or strangulation. Therefore, the caregiver should be advised against co-sleeping with the infant to ensure the baby's safety.

3. The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse?

• A. His head is molded from fitting through the birth canal. It will become more round.
• B. We refer to that as 'cone head,' which is a temporary condition that goes away.
• C. It might mean that your baby sustained brain damage during birth, and could have delays.
• D. I think he looks just like you. Your head is much the same shape as your baby's.

Correct answer: A

Rationale: The corrected response 'His head is molded from fitting through the birth canal. It will become more round.' is the best answer as it explains the physiological reason for the baby's appearance after birth. It reassures the father that the pointed and puffy-looking head is a normal part of the birthing process and will resolve on its own. Choice B is incorrect because while 'cone head' is a term used colloquially, it does not provide a detailed explanation. Choice C is incorrect and should be avoided as it introduces unnecessary worry by suggesting brain damage. Choice D is not an appropriate response as it doesn't address the father's concern or provide accurate information about newborn physiology.

4. What is the appropriate technique for performing two-rescuer CPR on a 4-year-old child?

• A. 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute.
• B. 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.
• C. 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.
• D. 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds.

Correct answer: C

Rationale: When performing two-rescuer CPR on a 4-year-old child, the appropriate technique involves 15 compressions to 2 ventilations. Compressions should be done by pressing the child's sternum with the heel of your hand. Ventilations should be given until visible chest rise occurs. This technique ensures effective CPR delivery for a child in need of resuscitation.

5. As a nurse caring for Asana, a 9-year-old girl with the stature of a 4-year-old due to growth hormone deficiency, which of the following will be your priority during follow-up visits?

• A. Vital signs monitoring
• B. Height and weight monitoring
• C. Bone age studies
• D. Dietary assessment

Correct answer: B

Rationale: Height and weight monitoring are essential for evaluating the growth progress in a child with growth hormone deficiency. Regular monitoring helps assess the effectiveness of treatment and ensures appropriate growth trajectory for the child.

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