Nursing Elites

1. The nurse is performing an assessment on a 12-month-old infant. Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills?

• A. Standing
• B. Sitting without assistance
• C. Fully developed pincer grasp
• D. Taking a few steps holding onto something

Correct answer: C

Rationale: The development of a pincer grasp reflects fine motor skills, which develop in a proximodistal pattern (from the center of the body outward).

2. What major complication is associated with a child with chronic renal failure?

• A. Hypokalemia
• B. Metabolic alkalosis
• C. Water and sodium retention
• D. Excessive excretion of blood urea nitrogen

Correct answer: C

Rationale: Water and sodium retention is a major complication in chronic renal failure, leading to hypertension and edema. Hypokalemia and metabolic alkalosis are less common, and while BUN levels rise, retention rather than excretion is problematic in chronic renal failure.

3. What is the most important intervention in the management of a child with sickle cell crisis?

• A. Administration of iron supplements
• B. Initiation of high-calorie diet
• C. Administration of pain relief
• D. Limiting fluid intake

Correct answer: C

Rationale: The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications. Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis. Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis. Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.

4. What is the number one leading cause of death in children over 1 year of age?

• A. Congenital anomalies
• B. Homicide
• C. Suicide
• D. Accidents

Correct answer: D

Rationale: Accidents, such as motor vehicle accidents, drowning, and falls, are the primary cause of death in children over 1 year of age. While congenital anomalies can be a significant cause of mortality in infants, they are less common in older children. Homicide and suicide are serious issues but are not as prevalent as accidents in causing death among children over 1 year of age.

5. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

• A. Postpone starting the IV until the next shift.
• B. Start the IV line and then allow for expression of feelings.
• C. Change the route of the antibiotics to PO.
• D. Postpone starting the IV line until the child is ready.

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

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