Nursing Elites

1. Apgar scoring is conducted at 1 minute and 5 minutes after birth. It is used to determine:

• A. Major body systems’ responses at birth
• B. Future intelligence of the newborn
• C. Level of parent and newborn interaction
• D. Gestational age of the newborn

Correct answer: A

Rationale: The Apgar score assesses a newborn's physical condition immediately after birth by evaluating heart rate, respiratory effort, muscle tone, reflex response, and color. Therefore, the correct answer is A. The other choices are incorrect because B) the Apgar score does not predict future intelligence, C) it does not measure parent and newborn interaction, and D) it is not used to determine gestational age.

2. A mother reports to the nurse that her 6-year-old child is highly active, irritable, irregular in habits, and adapts slowly to new routines, people, or situations. Which pattern of temperament would best describe the child?

• A. The 'easy' child
• B. The 'difficult' child
• C. The 'slow-to-warm-up' child
• D. The 'fast-to-warm-up' child

Correct answer: B

Rationale: The 'difficult' child is the best way to describe the child in this scenario. This temperament is characterized by high activity levels, irritability, irregular habits, and difficulty adapting to changes. Choice A, the 'easy' child, is known for being generally positive and adaptable. Choice C, the 'slow-to-warm-up' child, typically needs time to adapt to new situations but is not necessarily highly active or irritable. Choice D, the 'fast-to-warm-up' child, adapts quickly to new situations, which contrasts with the child's slow adaptation mentioned in the scenario.

3. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?

• A. Recheck head control at the next visit
• B. Teach the parents appropriate exercises
• C. Schedule the child for further evaluation
• D. Refer the child for further evaluation if the anterior fontanel is still open

Correct answer: C

Rationale: Significant head lag at 8 months is concerning and warrants further evaluation, as it may indicate developmental delays or neurological issues.

4. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

• A. The child may not be pain-free.
• B. The parents or nurse may push the button for a bolus if needed.
• C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
• D. Monitoring is required every 1 to 2 hours to assess patient response.

Correct answer: C

Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.

5. Which describe the feelings and behaviors of early preschool children related to divorce? (Select all that apply.)

• A. Regressive behavior
• B. Fear of abandonment
• C. Blame themselves for the divorce
• D. All of the above

Correct answer: D

Rationale: Preschool children may exhibit regressive behavior, fear abandonment, and blame themselves for their parents' divorce due to their limited understanding of the situation.

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