Nursing Elites

1. You are providing a home health care assessment for a very low-income mother with three young children under 5 who all appear to be at nutritional risk. Which program would you refer them to in an attempt to reduce the risk and safeguard the health of this family?

• A. Division of Maternal and Child Health
• B. Medicaid
• C. Supplemental Food Program for Women, Infants, and Children
• D. The State Children’s Health Insurance Program

Correct answer: C

Rationale: The correct answer is C, the Supplemental Food Program for Women, Infants, and Children (WIC). WIC provides nutritional assistance to low-income pregnant women, breastfeeding women, and children under 5. The Division of Maternal and Child Health (Choice A) focuses on promoting the health of mothers and children but does not provide direct nutritional assistance. Medicaid (Choice B) is a health insurance program for low-income individuals but does not specifically address nutritional needs. The State Children’s Health Insurance Program (Choice D) provides health insurance for children in low-income families but does not offer nutritional support like WIC does.

2. Why is it difficult to assess a child’s dietary intake?

• A. No systematic assessment tool has been developed
• B. Biochemical analysis for assessing nutrition is expensive
• C. Families usually do not understand much about nutrition
• D. Recall of food consumption is frequently unreliable

Correct answer: D

Rationale: The correct answer is D. Recall of food intake, especially amounts eaten, is often unreliable. While systematic tools like the 24-hour recall and dietary history questionnaires exist, recall can still be challenging in accurately assessing a child's dietary intake. Choices A, B, and C are incorrect because systematic assessment tools do exist, biochemical analysis is not the primary method for dietary assessment, and families' understanding of nutrition may vary but is not the main reason for the difficulty in assessing a child's dietary intake.

3. A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. How should the nurse respond?

• A. Tell the parents they can stay in the hospital but not on the unit
• B. Read the rules and regulations of rooming in with the child
• C. Let the parents know they are allowed to stay with the child
• D. Explain to the parents why they cannot stay with the child

Correct answer: C

Rationale: The correct response is to let the parents know they are allowed to stay with the child. Allowing parents to stay with the child can help reduce the child's anxiety and provide comfort. Choice A is incorrect as the parents should be encouraged to stay with their child. Choice B is not the immediate response the nurse should provide. Choice D is inappropriate as it does not address the benefits and importance of parental presence for the child's well-being during hospitalization.

4. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action?

• A. Ask the parent when the neck was injured
• B. Refer for immediate medical evaluation
• C. Continue assessment to determine the cause of the neck pain
• D. Record head lag on the assessment record and continue the assessment of the child

Correct answer: B

Rationale: Opisthotonos with pain on flexion is a sign of possible meningitis or other serious neurological conditions, requiring immediate medical evaluation.

5. According to Piaget, which principle supports a nine-year-old child's understanding that an arm will look the same when the IV is removed?

• A. The principle of conservation
• B. The principle of transductive reasoning
• C. The principle of identity
• D. The principle of reflex abilities

Correct answer: A

Rationale: The correct answer is A, the principle of conservation. Piaget's principle of conservation relates to a child's ability to understand that certain properties of objects remain unchanged despite modifications in their appearance. In this case, the child's understanding that an arm will look the same after the IV is removed demonstrates conservation of appearance. Choice B, transductive reasoning, involves making faulty generalizations based on specific instances and does not apply in this context. Choice C, the principle of identity, pertains to recognizing objects as the same even if they undergo transformations, which is not directly relevant to the scenario. Choice D, reflex abilities, refers to automatic responses to stimuli and is unrelated to the child's understanding of the arm's appearance post-IV removal.

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