Nursing Elites

1. What is the most common cause of acute gastroenteritis in children under 5 years?

• A. Salmonella
• B. Rotavirus
• C. Norovirus
• D. Shigella

Correct answer: B

Rationale: Rotavirus is the leading cause of acute gastroenteritis in children under 5 years. It leads to severe diarrhea and dehydration. Vaccination against rotavirus has significantly reduced the incidence of this disease, but it remains a major cause of morbidity in young children globally. Salmonella and Shigella can cause gastroenteritis, but they are less common in children under 5 years. Norovirus is also a common cause of gastroenteritis, but Rotavirus is the most prevalent in this age group.

2. Physiologically, the child compensates for fluid volume losses by which mechanism?

• A. Inhibition of aldosterone secretion
• B. Hemoconcentration to reduce cardiac workload
• C. Fluid shift from interstitial space to intravascular space
• D. Vasodilation of peripheral arterioles to increase perfusion

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

3. Children may believe that they are responsible for their parents' divorce and interpret the separation as punishment. At which age is this most likely to occur?

• A. 1 year
• B. 4 years
• C. 8 years
• D. 13 years

Correct answer: C

Rationale: At around 8 years old, children may feel they are responsible for their parents' divorce and view it as a punishment, which can impact their emotional well-being.

4. What is an important priority in dealing with the child suspected of having Wilms tumor?

• A. Intervening to minimize bleeding
• B. Monitoring temperature for infection
• C. Ensuring the abdomen is protected from palpation
• D. Teaching parents how to manage parenteral nutrition

Correct answer: C

Rationale: The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.

5. A parent and 4-year-old child are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the child doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?

• A. Reading a book
• B. Singing a song he learned at preschool
• C. Opening drawers in the room, pulling out supplies, and examining them
• D. Roughhousing with the parent

Correct answer: C

Rationale: The correct answer is C. According to Erikson, the primary task of a preschool-aged child is to explore and assert control over their environment. This behavior is demonstrated by the child opening drawers, pulling out supplies, and examining them, showcasing curiosity and exploration. Choices A, B, and D do not align with the primary developmental task of a preschool-age child according to Erikson. Reading a book and singing a song are more passive activities, while roughhousing with the parent does not directly relate to exploration and asserting control over the environment.

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