Nursing Elites

1. The nurse has completed an education program on normal communication abilities in the preschool-age child. Which statement by a participant indicates a need for further education?

• A. When my child counts numbers, it is only to 10 and we are slowly working on counting higher.
• B. I am glad to know that my 4-year-old child asking so many questions is normal.
• C. Stating his name and address is too hard for my 5-year-old child; it will be another year before he can do that.
• D. My child is finally talking in a way that most of my friends can understand her speech.

Correct answer: C

Rationale: The correct answer is C. By age 5, children should be able to state their name and address. If a child cannot do this, it may indicate a developmental delay that requires further assessment. Choices A, B, and D do not indicate a need for further education as they reflect typical developmental milestones for preschool-age children, such as gradually improving counting skills, asking many questions, and improving speech clarity over time.

2. When a pre-school child says the sun shines to keep her warm, this is an example of:

• A. Animism
• B. Artificialism
• C. Egocentrism
• D. Centering

Correct answer: B

Rationale: The correct answer is B: Artificialism. Artificialism is the belief that natural phenomena are created by human beings for human purposes. In this scenario, the child attributes human-like intentions to the sun, assuming it shines specifically to keep her warm. Choice A, Animism, is the belief that natural objects and phenomena are alive and have feelings. Choice C, Egocentrism, refers to a child's difficulty in seeing things from another person's perspective. Choice D, Centering, involves focusing on only one aspect of a situation while ignoring other relevant aspects.

3. Which reflex is expected to disappear by 4 months of age?

• A. Rooting reflex
• B. Moro reflex
• C. Babinski reflex
• D. Palmar grasp

Correct answer: B

Rationale: The Moro reflex, also known as the startle reflex, typically disappears by 4 months as the infant's nervous system matures. This reflex is important for assessing the development of the nervous system in newborns. The Rooting reflex (Choice A) is related to turning the head in response to cheek stimulation; the Babinski reflex (Choice C) involves the fanning of toes in response to foot stimulation; and the Palmar grasp (Choice D) is the curling of the fingers around an object placed in the infant's hand. These reflexes have different timelines for disappearance and are not typically expected to be gone by 4 months of age.

4. What is the primary symptom of congenital diaphragmatic hernia in a newborn?

• A. Cyanosis
• B. Bradycardia
• C. Absent breath sounds
• D. Tachypnea

Correct answer: C

Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.

5. Kimberly is having a checkup before starting kindergarten. The nurse asks her to do the “finger-to-nose test.” What is the purpose of this test?

• A. Deep tendon reflexes
• B. Cerebellar function
• C. Sensory discrimination
• D. Ability to follow directions

Correct answer: B

Rationale: The finger-to-nose test assesses cerebellar function, which is responsible for balance and coordination. The test evaluates how well the cerebellum controls motor functions and coordination. Choice A, deep tendon reflexes, is incorrect because this test does not assess reflexes but rather cerebellar function. Choice C, sensory discrimination, is incorrect as this test focuses on motor function rather than sensory abilities. Choice D, ability to follow directions, is incorrect since the test primarily assesses motor coordination and not cognitive skills related to following instructions.

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