Nursing Elites

1. The nurse is evaluating the growth and development of a toddler with AIDS. The nurse would anticipate finding that the child has

• A. Achieved developmental milestones at an erratic rate
• B. Delay in musculoskeletal development
• C. Displayed difficulty with speech development
• D. Delay in achievement of most developmental milestones

Correct answer: D

Rationale: Children with AIDS often experience delays in achieving developmental milestones, affecting their overall growth and development. This delay can impact various areas of development, not limited to a specific aspect like musculoskeletal or speech development. While some children may achieve milestones at varying rates (choice A), the general trend is a delay in multiple milestones (choice D). Musculoskeletal development (choice B) and speech development (choice C) may be affected but are not as comprehensive as the delay in most developmental milestones.

2. Which of the following qualifications is not required for a Nurse Supervisor at the provincial level?

• A. BSN, RN
• B. at least 3 years experience
• C. Master's in public health
• D. at least 5 years experience in public health

Correct answer: B

Rationale: The correct answer is B because the qualifications for a Nurse Supervisor at the provincial level include a BSN, RN, and a Master's in public health, along with a minimum of 5 years of experience in public health. Choice B, which states 'at least 3 years experience,' is incorrect as the requirement is for at least 5 years of experience in public health. Choices A, C, and D are necessary qualifications for a Nurse Supervisor at the provincial level based on the provided information.

3. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse or a practical nurse?

• A. assessment of the speech pattern of a mobile adult who had a mild stroke last year
• B. safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting
• C. wound care for a client who had postoperative infection following abdominal surgery two weeks ago
• D. evaluation of crutch use by a 65-year-old client who broke his tibia while snow skiing

Correct answer: C

Rationale: The correct answer is C because wound care for a postoperative infection qualifies for Medicare reimbursement. Medicare typically covers skilled nursing care, like wound care, required due to a postoperative infection. Choices A, B, and D involve assessments, teaching, and evaluation, which may not always be eligible for Medicare reimbursement unless they are directly related to skilled nursing care for a specific medical condition.

4. While explaining an illness to a 10-year-old, what should the nurse keep in mind about the cognitive development at this age?

• A. They are able to make simple associations of ideas
• B. They are able to think logically in organizing facts
• C. Interpretation of events originates from their own perspective
• D. Conclusions are based on previous experiences

Correct answer: B

Rationale: Correct answer: At the age of 10, children are in the stage of concrete operational thought, where they can think logically and organize facts. Choice A is incorrect as simple associations of ideas are more characteristic of earlier developmental stages. Choice C is incorrect as while children at this age are developing perspective-taking skills, their interpretations are not solely limited to their own perspective. Choice D is incorrect as while previous experiences influence their thinking, the ability to think logically and organize facts is more prominent in this stage of cognitive development.

5. The appropriate order of steps in active management of the third stage of labor includes:

• A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to ensure the placenta is intact.
• B. Intravenous oxytocin, cord clamping and cutting, and fundal massage.
• C. Intramuscular injection of oxytocin, controlled cord traction with counter traction to the uterus, and uterine massage.
• D. Controlled cord traction, fundal massage, and oxytocin.

Correct answer: C

Rationale: The correct sequence of steps in active management of the third stage of labor includes intramuscular injection of oxytocin to prevent postpartum hemorrhage, controlled cord traction with counter traction to the uterus to facilitate placental delivery, and uterine massage to aid in uterine contraction and prevent excessive bleeding. Choice A is incorrect because ergometrine administration is not routinely recommended in active management. Choice B is incorrect as intravenous oxytocin is not the preferred route of administration. Choice D is incorrect as the order of steps is not accurate.

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