Nursing Elites

1. 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.

2. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

3. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?

• A. Identity vs. role diffusion
• B. Trust vs. mistrust
• C. Industry vs. inferiority
• D. Autonomy vs. shame and doubt

Correct answer: A

Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.

4. As children grow and develop, their style of play changes. Which play style is descriptive of the school-age child?

• A. Plays alone but not with other children
• B. Plays games with other children and is able to follow the rules of the game
• C. Plays alone with play directed by others
• D. Plays with others in loose groups

Correct answer: B

Rationale: The correct answer is B. School-age children are typically able to play structured games with other children and follow the rules of the game. This ability reflects their growing cognitive and social development. Choice A is incorrect as school-age children often engage in group play. Choice C is incorrect as school-age children usually have more autonomy in their play choices. Choice D is incorrect as school-age children tend to form more organized play settings rather than loose groups.

5. The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.)

• A. Advertising of unhealthy food can increase snacking
• B. Increased screen time may be related to unhealthy sleep
• C. There is a link between the amount of screen time and obesity
• D. All of the above

Correct answer: D

Rationale: Increased screen time is associated with unhealthy habits, such as poor sleep and snacking, which contribute to obesity, but it does not necessarily improve nutrition knowledge.

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