Nursing Elites

1. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?

• A. Indicative of maladjustment
• B. A common reaction to divorce
• C. Suggestive of a lack of adequate parenting
• D. An unusual response that indicates a need for referral

Correct answer: B

Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.

2. The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?

• A. Tinnitus
• B. Disorientation
• C. Stupor, lethargy, and coma
• D. Edema of the lips, tongue, and pharynx

Correct answer: D

Rationale: Edema of the lips, tongue, and pharynx is a characteristic sign of corrosive poisoning, indicating damage to mucous membranes from ingestion of a caustic substance. Other symptoms may vary depending on the poison but are not as specific to corrosive ingestion.

3. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)

• A. All below
• B. A well-defined light reflex
• C. A small, round, concave spot near the center of the drum
• D. The tympanic membrane is a nontransparent grayish color

Correct answer: A

Rationale: A well-defined light reflex, a small concave spot, and a grayish, nontransparent tympanic membrane are normal findings during an otoscopic examination in a child.

4. Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?

• A. Autosomal dominant disorder in which the blood clotting factors are deficient.
• B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
• C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
• D. Autosomal recessive disorder in which the blood clotting factors are deficient.

Correct answer: B

Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.

5. At what age is binocularity, the ability to fixate on one visual field with both eyes simultaneously, typically achieved?

• A. 1 month
• B. 3 to 4 months
• C. 6 to 8 months
• D. 12 months

Correct answer: B

Rationale: Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is typically achieved by the age of 3 to 4 months. Achieving binocularity at 1 month is too early for most infants as their visual system is still developing. Similarly, 6 to 8 months and 12 months are beyond the normal age range for achieving binocularity, and delayed achievement could indicate potential issues like strabismus, which may lead to visual impairment if not addressed.

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