Nursing Elites

1. What findings would the nurse consider normal in assessing the anterior fontanel of a neonate?

• A. Closed anterior fontanel
• B. Sunken anterior fontanel
• C. Bulging anterior fontanel
• D. Pulsating anterior fontanel

Correct answer: D

Rationale: The correct answer is D: Pulsating anterior fontanel. The fontanel should feel flat, firm, and well demarcated. Pulsations are frequently visible at the anterior fontanel, which is a normal finding in a neonate. A closed anterior fontanel, as mentioned, is a potential sign of a major abnormality. A sunken or bulging fontanel (when the infant is quiet) may be indicative of distress or a major abnormality. Therefore, options A, B, and C are considered abnormal findings when assessing the anterior fontanel of a neonate.

2. The nurse is caring for an adolescent who is overweight. Which of the following psychological effects of being overweight during adolescence will the nurse consider when planning care for the adolescent?

• A. Poor body image
• B. Sexual promiscuity
• C. Feelings of contempt for thin peers
• D. Lack of independence

Correct answer: A

Rationale: Adolescents who are overweight often struggle with poor body image, which can lead to low self-esteem and mental health issues. Addressing body image concerns and promoting healthy lifestyle changes are important aspects of care. Choices B, C, and D are incorrect. Sexual promiscuity is not a direct psychological effect of being overweight; feelings of contempt for thin peers are not a common or recommended psychological response; lack of independence is a broad term that does not specifically relate to the psychological effects of being overweight.

3. The nurse is caring for a child with Neuroblastoma. Where is the tumor most commonly located?

• A. Bone
• B. Kidneys
• C. Cortex
• D. Abdomen

Correct answer: D

Rationale: Neuroblastoma is a cancer that commonly originates in the adrenal glands located in the abdomen. It can also occur in nerve tissues along the spine, but it is most frequently found in the abdominal region. Therefore, the correct answer is D. Choices A, B, and C are incorrect as Neuroblastoma typically arises from neural crest cells in the adrenal glands or sympathetic ganglia, not in the bones, kidneys, or cortex.

4. What approach is the most appropriate when performing a physical assessment on a toddler?

• A. Demonstrate the use of equipment
• B. Perform traumatic procedures last
• C. Use minimum physical contact initially
• D. Always proceed systematically in a head-to-toe direction

Correct answer: C

Rationale: The most appropriate approach when performing a physical assessment on a toddler is to use minimum physical contact initially. This helps gain the toddler's cooperation and reduces their distress. Performing traumatic procedures last is crucial as they are likely to upset the child and should be handled with care. Demonstrating the use of equipment may be complex for toddlers to understand, so it is not the most appropriate initial approach. Proceeding systematically in a head-to-toe direction is a good practice but using minimum physical contact initially is more important to establish trust and cooperation with the toddler.

5. At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?

• A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
• B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
• C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
• D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.

Correct answer: D

Rationale: Encouraging the baby to fall asleep in the crib while still awake can help establish healthy sleep habits and reduce night waking.

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