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. Which characteristic best describes the fine motor skills of an infant at age 5 months?

• A. Neat pincer grasp
• B. Strong grasp reflex
• C. Builds a tower of two cubes
• D. Able to grasp object voluntarily

Correct answer: D

Rationale: By 5 months, infants develop the ability to grasp objects voluntarily, showing improved motor control. The neat pincer grasp and building towers are skills that develop later.

3. Which of the following is a characteristic finding in Kawasaki disease?

• A. Strawberry tongue
• B. Polyarthritis
• C. Hematuria
• D. Rashes

Correct answer: A

Rationale: A 'strawberry tongue' is a characteristic finding in Kawasaki disease. The presence of a 'strawberry tongue' is a classic sign of Kawasaki disease, along with other features such as conjunctivitis and rash. Choice B, polyarthritis, is not typically seen in Kawasaki disease. Choice C, hematuria, is not a common finding in Kawasaki disease but may be seen in other conditions. Choice D, rashes, are present in Kawasaki disease but are not as specific or characteristic as the 'strawberry tongue'. Therefore, the correct answer is A.

4. What problem is most often associated with myelomeningocele?

• A. Biliary atresia
• B. Hydrocephalus
• C. Craniostenosis
• D. Tracheoesophageal fistula

Correct answer: B

Rationale: Hydrocephalus is the most commonly associated problem with myelomeningocele, present in 80% to 90% of affected children. Biliary atresia and tracheoesophageal fistula are not typically associated with myelomeningocele. Craniostenosis refers to the premature closing of cranial sutures and is not a common issue seen with myelomeningocele.

5. Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play is this?

• A. Cooperative play
• B. Solitary play
• C. Parallel play
• D. Associative play

Correct answer: C

Rationale: The correct answer is C, parallel play. Parallel play is observed when children play alongside each other but do not directly interact. In this scenario, each child is engaged in their own activity without engaging or influencing each other's play, which characterizes parallel play. Cooperative play (choice A) involves children playing together towards a common goal, which is not evident in the given situation. Solitary play (choice B) is when a child plays alone, unrelated to the presence of others. Associative play (choice D) involves more interaction and sharing of toys between children, which is not happening in the described play scenario.

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