Nursing Elites

1. At a well-visit, a mother voices concern that her 30-month-old has a smaller vocabulary than other children in his daycare. The nurse should:

• A. Admit the child to the hospital
• B. Assess the child for other age-appropriate development
• C. Suggest that the child is hearing impaired
• D. Explain that the child has a significant developmental delay

Correct answer: B

Rationale: When a parent expresses concern about a child's development, it is essential to conduct a comprehensive assessment of all areas of development before jumping to conclusions. Choosing option B allows the nurse to evaluate the child for other age-appropriate developmental milestones to determine if there are any delays or concerns. Admitting the child to the hospital (option A) is not necessary at this point and may cause unnecessary stress. Suggesting hearing impairment (option C) without proper evaluation can lead to misdiagnosis. Explaining a significant developmental delay (option D) should only be done after a thorough assessment and diagnosis.

2. 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.

3. A child is admitted with renal failure. Which of these findings should the nurse expect?

• A. Decreased BUN
• B. Azotemia and oliguria
• C. Increased glomerular filtration rate (GFR)
• D. Polyuria and elevated creatinine clearance

Correct answer: B

Rationale: Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.

4. After teaching a group of nursing students about developmental milestones for children between the ages of 1 and 4 years, the instructor determines that the teaching was successful when the students identify which of the following as a gross motor developmental milestone that occurs between 2 to 3 years of age?

• A. Jumping in place
• B. Climbing
• C. Standing on one foot with help
• D. Riding a tricycle

Correct answer: B

Rationale: Climbing is a gross motor milestone typically achieved between 2 to 3 years of age. It involves coordination and strength. Jumping in place is usually mastered around 2 years of age. Standing on one foot with help is a skill that emerges around 3 years. Riding a tricycle typically occurs closer to 3 years and involves coordination and balance, which are more refined skills compared to climbing at an earlier age.

5. What statement is descriptive of renal transplantation in children?

• A. It is an acceptable means of treatment after age 10 years.
• B. Children can receive kidneys only from other children.
• C. It is the preferred means of renal replacement therapy in children.
• D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Correct answer: C

Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.

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