Nursing Elites

1. You are developing a plan of care for a hospitalized child. Which age group is most likely to view illness as a punishment for misdeeds?

• A. Adolescence
• B. Preschool age
• C. Infancy
• D. School age

Correct answer: B

Rationale: Preschool-aged children often engage in magical thinking, where they may believe that illness is a punishment for misdeeds. This belief is related to their cognitive development stage, where they may attribute cause and effect in a magical or unrealistic way. Adolescents are more likely to view illness as a disruption to their sense of independence or control. Infants lack the cognitive development to associate illness with punishment for misdeeds. School-aged children typically have a more concrete understanding of illness and its causes, moving away from magical thinking.

2. A 12-year-old child had an appendectomy 18 hours ago. The nurse is monitoring the child for pain control. Which of the following tools is most appropriate for assessing the child’s pain?

• A. FLACC scale
• B. Numeric scale
• C. NIPS scale
• D. FACES scale

Correct answer: B

Rationale: The Numeric scale is the most appropriate tool for assessing pain in older children, like a 12-year-old, as they can comprehend and use numbers to indicate their pain levels accurately. The FLACC scale is typically used for nonverbal or preverbal children. The NIPS scale is designed for neonates and infants. The FACES scale is more commonly used in younger children who may have difficulty expressing their pain in other ways.

3. A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?

• A. It is unnecessary because of child’s age.
• B. It is essential because it will be an adjustment.
• C. Preparation is not needed because the colostomy is temporary.
• D. Preparation is important because the child needs to deal with negative body image.

Correct answer: B

Rationale: Preparation is essential even for a young child, as they need to adjust to the temporary colostomy and understand the changes to their body, which can be confusing and distressing without proper explanation.

4. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

• A. Purposeful and goal-directed
• B. A simple developmental process
• C. Based on deliberate and irrational thought
• D. Assists individuals in guessing what is most appropriate

Correct answer: A

Rationale: Clinical reasoning is purposeful and goal-directed, involving the use of critical thinking and decision-making skills to provide effective patient care.

5. Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?

• A. Vary the schedule for routine activities on a daily basis.
• B. Be persistent through 10 to 15 minutes of food refusal.
• C. Avoid solids until after the bottle is well accepted.
• D. Use developmental stimulation by a specialist during feedings.

Correct answer: B

Rationale: Being persistent through 10 to 15 minutes of food refusal is recommended to help increase caloric intake in infants with FTT. Establishing a routine and using developmental stimulation can also be helpful, but the priority is ensuring adequate caloric intake.

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