Nursing Elites

1. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?

• A. Rinne test
• B. Weber test
• C. Pure tone audiometry
• D. Eliciting the startle reflex

Correct answer: C

Rationale: Pure tone audiometry is an appropriate and effective screening test for hearing in a 5-year-old child, helping to assess the ability to hear various frequencies and volumes.

2. The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?

• A. Hypertension
• B. Pain at the entry site
• C. Fever and general malaise
• D. Redness and swelling at the entry site

Correct answer: C

Rationale: Fever and general malaise are systemic signs of bacteremia, indicating that the infection may have spread beyond the local entry site. Localized pain, redness, and swelling are signs of a localized infection but do not necessarily indicate bacteremia.

3. When should the dressing change for a post-op pediatric patient that is expected to be very painful and frightening be performed?

• A. In the patient’s room
• B. In the treatment room
• C. After discharge when the patient is at home
• D. In the playroom

Correct answer: B

Rationale: The correct answer is B: 'In the treatment room.' Performing painful procedures in the treatment room helps the child associate their own room with safety and comfort, not pain. Choice A is incorrect because performing the dressing change in the patient’s room may create a negative association with their safe space. Choice C is incorrect as it is important to ensure proper wound care and pain management before discharge. Choice D is incorrect as the playroom may not be equipped for a sterile dressing change.

4. An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?

• A. Renal colic
• B. Strong urinary stream
• C. Urinary tract infections
• D. Post urination dribbling

Correct answer: D

Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.

5. 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.

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