Nursing Elites

1. According to Freud’s developmental theory, infancy is a stage of:

• A. Orality
• B. Latency
• C. Genitality
• D. Anality

Correct answer: A

Rationale: In Freud’s psychosexual development theory, the oral stage is the first stage and occurs during infancy. It focuses on activities involving the mouth, such as sucking and feeding. This stage is crucial for the child's development as it forms the basis for trust and attachment. Choices B, C, and D are incorrect as latency refers to the stage during middle childhood where sexual impulses are suppressed, genitality refers to the final stage focusing on mature sexual relationships, and anality refers to the stage occurring during the toddler years where toilet training plays a significant role.

2. What is the first step in treating a child with suspected anaphylaxis?

• A. Administer oxygen
• B. Start an IV line
• C. Give epinephrine
• D. Monitor vital signs

Correct answer: C

Rationale: The correct answer is C: Give epinephrine. Administering epinephrine is the first and most critical step in treating anaphylaxis. Epinephrine rapidly reverses the symptoms of anaphylaxis, including airway swelling, hypotension, and shock. Delaying administration can lead to severe complications or death, making it essential in emergency treatment. Choice A, administering oxygen, might be necessary but should not delay the administration of epinephrine. Starting an IV line (Choice B) is important for further treatment but not the initial step. Monitoring vital signs (Choice D) is essential but comes after administering epinephrine to stabilize the child.

3. When should a child receive the first dose of the hepatitis B virus (HBV) vaccine if the mother is hepatitis B surface antigen (HBsAg) negative?

• A. 2 months of age, before hospital discharge.
• B. Birth before discharge from the hospital.
• C. 6 months of age, at the third well-child visit.
• D. No time (this vaccine is not currently recommended).

Correct answer: B

Rationale: If the mother is HBsAg negative, it is recommended that the child receives the first dose of the hepatitis B vaccine at birth before discharge from the hospital. This is to provide early protection against the hepatitis B virus. The second dose of the vaccine is typically given at the first well-child visit, and the third dose is usually administered at a later date. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Committee on Infectious Diseases of the American Academy of Pediatrics govern the recommendations for immunization, including the hepatitis B virus vaccine. Choice A is incorrect as the first dose should ideally be given at birth. Choice C is incorrect as waiting until 6 months of age may leave the child vulnerable to infection during the early months of life. Choice D is incorrect as the hepatitis B vaccine is recommended for all newborns, especially if the mother is HBsAg negative, to prevent transmission of the virus.

4. What is the most common cause of abdominal pain in school-aged children?

• A. Gastroenteritis
• B. Constipation
• C. Appendicitis
• D. Irritable bowel syndrome

Correct answer: B

Rationale: Constipation is the most common cause of abdominal pain in school-aged children. It is often due to dietary factors such as low fiber intake or insufficient fluid consumption. Chronic constipation can lead to complications like fecal impaction and soiling, highlighting the importance of early recognition and treatment. Gastroenteritis, although common, typically presents with diarrhea and vomiting. Appendicitis is more common in adolescents and typically presents with right lower quadrant pain. Irritable bowel syndrome is less common in children and is characterized by recurrent abdominal pain associated with defecation.

5. What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis?

• A. Bruising and lethargy
• B. Anorexia and malaise
• C. Fatigability and jaundice
• D. Dark urine and pale stools

Correct answer: B

Rationale: The correct answer is B: Anorexia and malaise. The prodromal phase of acute viral hepatitis is characterized by nonspecific symptoms such as anorexia (loss of appetite) and malaise (general feeling of discomfort). These symptoms typically precede the more specific signs of jaundice, dark urine, and pale stools that manifest in the icteric phase. Choices A, C, and D are incorrect because bruising and lethargy, fatigability and jaundice, and dark urine and pale stools are typically seen in later stages of acute viral hepatitis, not in the prodromal phase.

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