Nursing Elites

1. With the National Center for Health Statistics criteria, which body mass index (BMI)-for-age percentiles should indicate the patient is at risk for being overweight?

• A. 10th percentile
• B. 75th percentile
• C. 85th percentile
• D. 95th percentile

Correct answer: C

Rationale: A BMI-for-age at the 85th percentile indicates a child is at risk for being overweight, according to the National Center for Health Statistics criteria.

2. The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?

• A. The infant responds to his own name.
• B. The infant localizes sounds by turning his head directly to the sound.
• C. The infant turns his head to the side when sound is made at the level of the ear.
• D. The infant locates sound by turning his head to the side and then looking up or down.

Correct answer: C

Rationale: By 10 weeks, infants typically turn their heads to the side to locate the source of a sound made at ear level.

3. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?

• A. "We will give you your shot when your mommy comes back."
• B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
• C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
• D. "This is a magic sword that will give you your medicine and make you all better."

Correct answer: C

Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.

4. Play activities of the preschool-age child include:

• A. Having imaginary playmates
• B. Selective collection of objects
• C. Complex board games
• D. Associative play

Correct answer: A

Rationale: The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.

5. A parent brings their 4-year-old child for a check-up. Which finding would concern the nurse?

• A. Ectomorphic body type
• B. Resting pulse rate of 120
• C. Weight gain of 5 lb (2.27 kg) in the past year
• D. No increase in appetite compared with that in toddler years

Correct answer: B

Rationale: A resting pulse rate of 120 is elevated for a 4-year-old and may indicate an underlying issue that needs further investigation. An ectomorphic body type is a body shape and not typically a cause for concern. Weight gain within normal limits and no significant change in appetite are generally positive findings in a growing child.

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