Nursing Elites

1. What causes an older female client's hair to turn gray?

• A. ''A loss of melanin occurs in the normal aging process.''
• B. ''The number of sweat glands and blood vessels decreases in the normal aging process.''
• C. ''The skin on the scalp becomes thin, causing moisture to escape.''
• D. ''It is caused by hereditary factors.''

Correct answer: A

Rationale: The correct answer is 'A loss of melanin occurs in the normal aging process.' Graying hair in older adults is primarily due to a decrease in the number of melanocytes responsible for providing pigment and hair color. This reduction in melanin production leads to gray hair. The other choices are incorrect. While it is true that the skin becomes thinner with aging and the number of sweat glands and blood vessels decreases, these changes are not directly related to graying hair. Additionally, hereditary factors can influence when graying starts, but they do not cause the graying of hair itself.

2. The patient is inquiring about the use of a PCA pump for pain management. Which statement by the patient indicates a need for additional education?

• A. "I will continue to report my pain score during assessments."?
• B. "I understand that there is a maximum dose per hour that I can receive regardless of how many times I press the button."?
• C. "I believe this new PCA pump will finally alleviate my back pain."?
• D. "I have more control over when and how much medication I receive."?

Correct answer: C

Rationale: The correct answer is, "I believe this new PCA pump will finally alleviate my back pain."? This statement indicates a need for additional education as it reflects an unrealistic expectation regarding pain management. It is essential for the patient to understand that while a PCA pump can provide effective pain relief, it may not completely eliminate pain. Option A is correct as it demonstrates the patient's understanding of the importance of reporting pain scores for proper pain management. Option B is correct as it shows the patient's awareness of the maximum dose limits to prevent overdose. Option D is correct as it highlights the patient's understanding of the control they have over their medication administration.

3. When evaluating a kinetic family drawing, which of the following actions is most effective?

• A. asking the child to draw their family doing something
• B. offering specific suggestions of what to include in the drawing
• C. discouraging the child from talking about the drawing
• D. noting the omission of any family members

Correct answer: D

Rationale: When evaluating a kinetic family drawing, noting the omission of any family members is an effective action. It is crucial to observe and analyze all aspects of the drawing, including what is missing. This can provide valuable insights into the child's perception and relationships within the family. Asking the child to draw their family doing something (Choice A) is more related to initial instruction rather than evaluation. Offering specific suggestions (Choice B) can influence the child's drawing and should be avoided to maintain the authenticity of the representation. Discouraging the child from talking about the drawing (Choice C) is counterproductive as verbal expression can provide additional context and understanding.

4. When teaching parents how their children learn sex role identification, the nurse should include which of the following statements?

• A. Sex role identification begins in infancy.
• B. Sex role identification begins in the preschool years.
• C. Sex role identification begins during the school-age years.
• D. Sex role identification begins during early adolescence.

Correct answer: A

Rationale: Sex role identification begins during infancy as infants can identify body parts by the end of the first year. Preschoolers often engage in masturbation and sex play. School-age children continue to develop awareness of their sexual identity, including behaviors like hugging and kissing. Early adolescence sees further development influenced by sexual maturation and experimentation with sex roles. Therefore, the correct statement is that sex role identification begins in infancy. Choices B, C, and D are incorrect as they misrepresent the timeline of the development of sex role identification in children.

5. In conducting a health screening for 12-month-old children, the nurse expects them to have been immunized against which of the following diseases?

• A. measles, polio, pertussis, hepatitis B
• B. diphtheria, pertussis, polio, tetanus
• C. rubella, polio, pertussis, hepatitis A
• D. measles, mumps, rubella, polio

Correct answer: B

Rationale: By 12 months of age, children should have received vaccines for diphtheria, pertussis, polio, and tetanus (DTaP and IPV). The correct answer is B as it includes these vaccines that are typically administered in the first year of life. Measles, mumps, and rubella (MMR) vaccination usually begins at 12 months of age but is not expected to be completed by this time. Choices A and C are incorrect as they include diseases that are not part of the routine immunization schedule for a 12-month-old child.

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