Nursing Elites

1. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?

• A. Initiate a game of peek-a-boo.
• B. Ask the infant's father to place the infant on the examination table
• C. Talk softly to the infant while taking him from his father
• D. Undress the infant while he is still sitting on his father’s lap

Correct answer: A

Rationale: Engaging the infant in a familiar game like peek-a-boo can help reduce fear and build rapport before starting the assessment.

2. Play activities of the preschool-age child include:

• A. Having imaginary playmates
• B. Selective collection of objects
• C. Complex board games
• D. Associative play

Correct answer: A

Rationale: The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.

3. When auscultating an infant's lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?

• A. Suggestive of chronic pulmonary disease
• B. Suggestive of impending respiratory failure
• C. An abnormal finding warranting investigation
• D. A normal finding in infants younger than 1 year of age

Correct answer: C

Rationale: Diminished breath sounds in an infant are an abnormal finding and warrant further investigation to rule out conditions like atelectasis or pneumonia.

4. What is the first sign of puberty in girls?

• A. Acne
• B. Hair growth in the pubic area and underarms
• C. Thelarche
• D. Menarche

Correct answer: C

Rationale: The correct answer is C, Thelarche. Thelarche refers to the onset of breast development, which is typically the first sign of puberty in girls. This occurs before menarche (the first menstrual period). Choices A and B, acne and hair growth in the pubic area and underarms, are not the first signs of puberty in girls. While acne can be a common occurrence during puberty, it usually appears after other physical changes. Hair growth in the pubic area and underarms also occurs later in the puberty process.

5. The physician tells the parents of a 2-year-old that the child probably has RSV. The parents ask how the diagnosis will be confirmed. How should the nurse respond?

• A. We will swab your child's nose and send the secretions for testing.
• B. There is no specific test for RSV. The diagnosis is based on symptoms.
• C. We will send a viral culture to an outside lab for testing.
• D. There is no specific test for RSV. The diagnosis is based on symptoms.

Correct answer: A

Rationale: The correct answer is A. RSV is typically diagnosed by swabbing the nose and testing the secretions. This method helps confirm the presence of the respiratory syncytial virus. Choice B is incorrect because while symptoms are important in diagnosis, specific tests like swabbing for RSV do exist. Choice C is incorrect as sending a viral culture to an outside lab is not the primary method for diagnosing RSV. Choice D is a duplicate of choice B and is incorrect for the same reasons.

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