Nursing Elites

1. 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.

2. The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby’s formula faster. What should the nurse recommend?

• A. Heat only 8 oz or more.
• B. Do not heat a plastic bottle in a microwave oven.
• C. Leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Heating formula in a plastic bottle in the microwave can cause uneven heating and release harmful chemicals from the plastic.

3. The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as the infant should. What question would be appropriate for the nurse to ask in determining if their fears are warranted?

• A. Does the infant move a toy back and forth from one hand to the other?
• B. Is the infant able to drink from a cup by oneself?
• C. Is the infant able to hold a pencil and scribble on paper?
• D. Does the infant place toys into a box or container and take them out?

Correct answer: A

Rationale: The correct answer is A. By 8 months, an infant should be able to transfer objects between hands, which is an important motor skill milestone. This action shows coordination and developing fine motor skills. Choices B, C, and D involve more advanced motor skills that are typically not expected at 8 months of age. Drinking from a cup, holding a pencil to scribble, and engaging in purposeful play with toys are skills that develop later in infancy.

4. A new mom is instructed to have her toddler brush his teeth every night after dinner. This is an example of __________ which increases the toddler’s sense of security and self-mastery.

• A. Negativism
• B. Diversionary activity
• C. Critical play
• D. Ritualism

Correct answer: D

Rationale: The correct answer is D, Ritualism. Establishing routines like brushing teeth every night after dinner helps toddlers feel secure and in control. Choice A, Negativism, refers to a child's oppositional behavior. Choice B, Diversionary activity, involves redirecting attention to something else. Choice C, Critical play, does not relate to the scenario of establishing a routine for the toddler.

5. Which parental statement indicates correct understanding of information presented regarding the prevention of iron deficiency anemia in infants?

• A. "We will add green leafy vegetables to our child’s low-iron formula."
• B. "We will discontinue the use of vitamin C supplements by 6 months of age."
• C. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."
• D. "We will introduce cow’s milk by 6 months of age."

Correct answer: C

Rationale: The correct answer is C. Introducing iron-fortified cereal between 4 to 6 months of age is a recommended practice to prevent iron deficiency anemia in infants. Iron-fortified infant cereals are a good source of iron for infants. Choices A and B are incorrect because adding green leafy vegetables to low-iron formula and discontinuing vitamin C supplements do not directly address the prevention of iron deficiency anemia. Choice D is incorrect because cow's milk should be avoided before 12 months of age as it is low in iron and can lead to intestinal blood loss, increasing the risk of iron deficiency anemia.

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