Nursing Elites

1. Which of the following vaccines is not part of the regular schedule of immunizations for children?

• A. DTaP
• B. MMR
• C. Hib
• D. hepatitis A

Correct answer: D

Rationale: The correct answer is hepatitis A. DTaP, MMR, and Hib are all part of the regular schedule of immunizations for children to protect them against diseases like diphtheria, tetanus, pertussis, measles, mumps, rubella, and Haemophilus influenzae type b. Hepatitis A vaccine is not included in the routine childhood immunization schedule but may be recommended in certain situations or regions where the disease is more prevalent. Hepatitis A is generally considered an optional vaccine for children but can be administered based on specific risk factors or regional guidelines.

2. During a routine health screening for a 1-year-old child, what is the most critical topic for the nurse to discuss with the parents?

• A. the potential hazards of accidents
• B. appropriate nutrition now that the child has been weaned from breastfeeding
• C. toilet training
• D. how to purchase appropriate shoes now that the child is walking

Correct answer: A

Rationale: During a routine health screening for a 1-year-old child, the most critical topic for the nurse to discuss with the parents is the potential hazards of accidents. Accidents are the primary source of injury in children and can be life-threatening. Discussions about appropriate nutrition should have been addressed during the weaning process, while the purchase of appropriate shoes is important but not life-threatening. Toilet training typically begins around 2 years of age, so 1 year of age is too early to discuss it. Therefore, the focus should be on educating parents about accident prevention to ensure the child's safety and well-being.

3. A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?

• A. turning out the room light and closing the door
• B. tiring the child during the evening with quiet activities
• C. identifying the child's home bedtime rituals and following them
• D. encouraging visitation by friends during the evening

Correct answer: C

Rationale: For a 4-year-old client struggling to sleep in the hospital, it is essential to identify and replicate their home bedtime rituals. This familiarity can provide comfort and promote better sleep. Turning out the room light and closing the door (Choice A) might increase the child's fear by plunging the room into darkness, making it an incorrect choice. Tiring the child with quiet activities (Choice B) is incorrect as it may stimulate rather than calm the child. Encouraging visitation by friends (Choice D) can lead to increased excitement, hindering the child's ability to fall asleep instead of promoting a restful environment.

4. Which of the following is an example of an extended care facility?

• A. Home health agency
• B. Suicide prevention center
• C. State-owned psychiatric hospital
• D. Nursing facility

Correct answer: D

Rationale: An extended care facility typically provides long-term care for individuals who require continuous assistance with activities of daily living. A nursing facility fits this description as it offers skilled nursing care and assistance with daily activities. Choices A, B, and C are incorrect because a home health agency provides care in the patient's home, a suicide prevention center focuses on mental health crisis intervention, and a state-owned psychiatric hospital offers mental health treatment, none of which are synonymous with extended care facilities.

5. If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

• A. retrograde ejaculation
• B. decreased plasma testosterone
• C. hypertrophy of testicles
• D. state of euphoria

Correct answer: B

Rationale: In chronic renal failure, untreated, the client is at risk of developing decreased plasma testosterone. This condition leads to atrophy of the testicles and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure but can occur after transurethral resection of the prostate. The testicles atrophy in chronic renal failure; they do not hypertrophy. Additionally, chronic renal failure often leads to a state of depression, not euphoria.

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