Nursing Elites

1. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?

• A. A low-fiber diet is not always required.
• B. Stress management may be helpful.
• C. Milk products may or may not be a contributing factor.
• D. Pantoprazole (a proton pump inhibitor) is not a first-line treatment.

Correct answer: B

Rationale: The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.

2. Which type of play would be most beneficial for preparing a preschool-age child for upcoming surgery to reduce the stress of the event?

• A. Cooperative play
• B. Associative play
• C. Dramatic play
• D. Onlooker play

Correct answer: C

Rationale: Dramatic play involves role-playing, allowing children to act out scenarios and become more comfortable with them. This type of play can help reduce anxiety about upcoming events like surgery. Cooperative play involves working together towards a common goal, associative play involves loosely interacting with others, and onlooker play involves observing others play without actively participating. These types of play are not as directly related to preparing a child for surgery and reducing stress as dramatic play.

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. The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

• A. Place a warm moist pack on the scrotal area.
• B. Instruct the adolescent to lie down and elevate the legs.
• C. Refer the adolescent for immediate medical evaluation.
• D. Suggest that the adolescent wear a scrotum-protecting guard.

Correct answer: C

Rationale: Testicular torsion is a surgical emergency requiring immediate medical evaluation. Applying heat or elevating the legs will not alleviate the torsion, and delaying care can lead to testicular necrosis.

5. What is a physical characteristic of infants whose mothers smoked during pregnancy?

• A. Being large for gestational age
• B. Growth restriction in weight only
• C. Preterm but size appropriate for gestational age
• D. Growth restriction in weight, length, and chest and head circumference

Correct answer: D

Rationale: The correct answer is D: Growth restriction in weight, length, and chest and head circumference. Infants born to mothers who smoke during pregnancy exhibit growth failure in weight, length, chest, and head circumference. This growth failure is directly related to the number of cigarettes smoked by the mother. Choices A, B, and C are incorrect because infants exposed to maternal smoking do not tend to be large for gestational age, experience growth restriction in weight only, or be preterm but size appropriate for gestational age.

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