Nursing Elites

1. Which reflex is expected to disappear by 4 months of age?

• A. Rooting reflex
• B. Moro reflex
• C. Babinski reflex
• D. Palmar grasp

Correct answer: B

Rationale: The Moro reflex, also known as the startle reflex, typically disappears by 4 months as the infant's nervous system matures. This reflex is important for assessing the development of the nervous system in newborns. The Rooting reflex (Choice A) is related to turning the head in response to cheek stimulation; the Babinski reflex (Choice C) involves the fanning of toes in response to foot stimulation; and the Palmar grasp (Choice D) is the curling of the fingers around an object placed in the infant's hand. These reflexes have different timelines for disappearance and are not typically expected to be gone by 4 months of age.

2. What is the most common cause of abdominal pain in school-aged children?

• A. Gastroenteritis
• B. Constipation
• C. Appendicitis
• D. Irritable bowel syndrome

Correct answer: B

Rationale: Constipation is the most common cause of abdominal pain in school-aged children. It is often due to dietary factors such as low fiber intake or insufficient fluid consumption. Chronic constipation can lead to complications like fecal impaction and soiling, highlighting the importance of early recognition and treatment. Gastroenteritis, although common, typically presents with diarrhea and vomiting. Appendicitis is more common in adolescents and typically presents with right lower quadrant pain. Irritable bowel syndrome is less common in children and is characterized by recurrent abdominal pain associated with defecation.

3. What is the appropriate site to administer an intramuscular (IM) vaccine to a newborn?

• A. The dorsal gluteal muscle
• B. The vastus lateralis muscle
• C. The ventral gluteal muscle
• D. The biceps muscle

Correct answer: B

Rationale: The correct site to administer an intramuscular (IM) vaccine to a newborn is the vastus lateralis muscle. For newborns, the vastus lateralis is preferred over the dorsogluteal site because the dorsogluteal site has been associated with low antibody seroconversion rates, indicating a reduced immune response. The vastus lateralis is also recommended for IM injections in newborns, while the deltoid muscle is preferred for older infants and children. The ventral gluteal muscle and the biceps muscle are not appropriate sites for IM injections. Therefore, choice B is the correct answer.

4. The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse’s reply should be based on what?

• A. The child is too young to digest hot dogs.
• B. The child is too young to eat hot dogs safely.
• C. Hot dogs must be sliced into sections to prevent aspiration.
• D. Hot dogs must be cut into small, irregular pieces to prevent aspiration.

Correct answer: D

Rationale: Cutting hot dogs into small, irregular pieces reduces the risk of aspiration, which is a significant choking hazard for young children.

5. What is the first step in treating a child with suspected anaphylaxis?

• A. Administer oxygen
• B. Start an IV line
• C. Give epinephrine
• D. Monitor vital signs

Correct answer: C

Rationale: The correct answer is C: Give epinephrine. Administering epinephrine is the first and most critical step in treating anaphylaxis. Epinephrine rapidly reverses the symptoms of anaphylaxis, including airway swelling, hypotension, and shock. Delaying administration can lead to severe complications or death, making it essential in emergency treatment. Choice A, administering oxygen, might be necessary but should not delay the administration of epinephrine. Starting an IV line (Choice B) is important for further treatment but not the initial step. Monitoring vital signs (Choice D) is essential but comes after administering epinephrine to stabilize the child.

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