Nursing Elites

1. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)

• A. All below
• B. A well-defined light reflex
• C. A small, round, concave spot near the center of the drum
• D. The tympanic membrane is a nontransparent grayish color

Correct answer: A

Rationale: A well-defined light reflex, a small concave spot, and a grayish, nontransparent tympanic membrane are normal findings during an otoscopic examination in a child.

2. Which is an accurate description of homosexual (or gay-lesbian) families?

• A. A nurturing environment is lacking.
• B. The children become homosexual like their parents.
• C. The stability needed to raise healthy children is lacking.
• D. The quality of parenting is equivalent to that of nongay parents.

Correct answer: D

Rationale: Research shows that the quality of parenting in homosexual families is equivalent to that in heterosexual families, and children thrive in nurturing environments provided by same-sex parents.

3. What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis?

• A. Bruising and lethargy
• B. Anorexia and malaise
• C. Fatigability and jaundice
• D. Dark urine and pale stools

Correct answer: B

Rationale: The correct answer is B: Anorexia and malaise. The prodromal phase of acute viral hepatitis is characterized by nonspecific symptoms such as anorexia (loss of appetite) and malaise (general feeling of discomfort). These symptoms typically precede the more specific signs of jaundice, dark urine, and pale stools that manifest in the icteric phase. Choices A, C, and D are incorrect because bruising and lethargy, fatigability and jaundice, and dark urine and pale stools are typically seen in later stages of acute viral hepatitis, not in the prodromal phase.

4. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

• A. The hepatitis B vaccination series should be begun at birth
• B. All are applicable
• C. Any child not vaccinated at birth should receive two doses at least 4 months apart
• D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

5. Which condition is characterized by a 'seal-like' barking cough in children?

• A. Croup
• B. Asthma
• C. Bronchitis
• D. Pneumonia

Correct answer: A

Rationale: Croup is the correct answer. Croup is characterized by a 'seal-like' barking cough due to inflammation and narrowing of the upper airways, particularly the larynx and trachea. It is most common in young children and can cause significant respiratory distress, especially at night. Treatment often includes humidified air and corticosteroids. Asthma (choice B) typically presents with wheezing and shortness of breath, not a barking cough. Bronchitis (choice C) is characterized by productive cough with mucus, not a barking cough. Pneumonia (choice D) often presents with fever, productive cough, and chest pain, not a barking cough.

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