a 13 year old boy comes to the school nurse complaining of sudden and severe scrotal pain he denies any trauma to the scrotum what is the most appropr
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Nursing Elites

ATI RN

RN Nursing Care of Children Online Practice 2019 A

1. A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?

Correct answer: A

Rationale: Sudden and severe scrotal pain in an adolescent male is a medical emergency and may indicate testicular torsion, which requires immediate evaluation and intervention to prevent testicular loss.

2. What statement is most descriptive of Meckel diverticulum?

Correct answer: B

Rationale: The correct answer is B. Meckel diverticulum often presents with intestinal bleeding, which can vary in severity. It is a congenital condition, meaning it is present from birth, not acquired during childhood (choice A). Meckel diverticulum is slightly more common in males than in females, so it does not occur more frequently in females (choice C). While some cases of Meckel diverticulum may require surgical intervention, medical interventions can also be sufficient to treat the problem, so it is not always necessary to resort to surgery (choice D).

3. Which best describes signs and symptoms as part of a nursing diagnosis?

Correct answer: D

Rationale: Signs and symptoms are cues and clusters derived from patient assessments that are used to form a nursing diagnosis, guiding the development of a care plan.

4. Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Correct answer: A

Rationale: The correct answer is A: Sitting independently. By 11 months, most infants can sit independently. This milestone usually precedes walking, which typically occurs closer to 12 months. Turning a doorknob and building a tower of four cubes involve more complex motor skills that are typically achieved later in development. Therefore, at 11 months, sitting independently is the milestone that the nurse would expect an infant to have achieved.

5. The nurse is testing an infant's visual acuity. By which age should the infant be able to fix on and follow a target?

Correct answer: C

Rationale: By 3 to 4 months of age, an infant should be able to fix on and follow a target, indicating proper visual development.

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