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 is the most common cause of acute kidney injury in children?

• A. Dehydration
• B. Glomerulonephritis
• C. Hemolytic uremic syndrome
• D. Sepsis

Correct answer: C

Rationale: Hemolytic uremic syndrome is the most common cause of acute kidney injury in children. While dehydration can lead to prerenal acute kidney injury, it is not the most common cause in children. Glomerulonephritis is a common cause of chronic kidney disease but not typically the most common cause of acute kidney injury in children. Sepsis can lead to acute kidney injury, but in children, hemolytic uremic syndrome is more prevalent.

3. At what stage can infants raise their heads and gain control of their trunks before walking due to which directional pattern of development?

• A. Cephalocaudal
• B. Anterior to posterior
• C. Proximodistal
• D. Normal growth curve charts

Correct answer: A

Rationale: The correct answer is A: Cephalocaudal. The cephalocaudal pattern of development means that growth and motor control proceed from the head downward through the body. This explains why infants can raise their heads before they can sit and gain control of their trunks before walking. Choices B, C, and D are incorrect. Anterior to posterior refers to development from the front to the back, while proximodistal refers to development from the center of the body outward. Normal growth curve charts are used to track physical growth over time and are not directly related to the directional pattern of development in infants.

4. The nurse is aware that skin turgor best estimates what?

• A. Perfusion
• B. Adequate hydration
• C. Amount of body fat
• D. Amount of anemia

Correct answer: B

Rationale: Skin turgor is a quick and simple way to assess hydration status. Poor skin turgor can indicate dehydration.

5. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?

• A. At bedtime
• B. With a meal
• C. Midmorning
• D. 30 minutes before breakfast

Correct answer: D

Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.

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