Nursing Elites

1. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

2. Which data should be included in a health history?

• A. Review of systems
• B. Physical assessment
• C. Growth measurements
• D. Record of vital signs

Correct answer: A

Rationale: The review of systems is a critical part of a health history, helping to identify any symptoms or conditions that need further evaluation.

3. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?

• A. Identity vs. role diffusion
• B. Trust vs. mistrust
• C. Industry vs. inferiority
• D. Autonomy vs. shame and doubt

Correct answer: A

Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.

4. The nurse is caring for a 2-year-old child in the postoperative period. Which pain assessment tool is most appropriate for assessing pain intensity in a 2-year-old?

• A. Poker chip tool
• B. Oucher Scale
• C. Faces Pain Rating Scale
• D. FLACC Behavioral Pain Assessment Scale

Correct answer: D

Rationale: The FLACC Behavioral Pain Assessment Scale is the most suitable tool for assessing pain in 2-year-old children postoperatively. It assesses pain by evaluating facial expression, leg movement, activity, cry, and consolability, making it effective for non-verbal children. The Poker chip tool is not appropriate for this age group. The Oucher Scale and Faces Pain Rating Scale are more suitable for older children who can self-report pain levels.

5. Two children are working on a puzzle together in the hospital playroom. Which type of play describes this activity?

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

Correct answer: D

Rationale: The correct answer is D, cooperative play. In cooperative play, children work together toward a common goal, such as completing a puzzle. Solitary play (A) is when a child plays alone, associative play (B) involves children playing together but without a common goal, and parallel play (C) is when children play alongside each other without direct interaction.

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