Nursing Elites

1. Difficulties with eating, sleeping, playing, repetitive or difficult behaviors, and paying attention may all be caused in part by which of the following?

• A. Cognitive delays
• B. Lack of motivation for mastery
• C. Sensory processing challenges
• D. Imitation deficits

Correct answer: C

Rationale: Sensory processing challenges can affect various aspects of a child's daily life, including eating, sleeping, playing, behavior, and attention. These challenges can lead to difficulties in processing sensory information, which may manifest in different behaviors and impact their overall functioning.

2. In an immunization clinic, which patient will the nurse identify as not eligible to receive routine immunizations?

• A. An 8-year-old experiencing diarrhea
• B. A 2-year-old with a history of pre-term birth
• C. A 4-year-old with a fever and upper respiratory tract infection
• D. A 6-year-old who has been recently exposed to a classmate with chickenpox

Correct answer: C

Rationale: The nurse should identify the 4-year-old with a fever and upper respiratory tract infection as not eligible to receive routine immunizations. It is contraindicated to administer vaccines in the presence of moderate to severe illness, whether with or without fever, to prevent potential complications or reduced vaccine efficacy.

3. Which statement by the parents indicates understanding of the process involved with a kidney transplant for a child with renal failure?

• A. We are happy that our child will not have to take any more medicine after the transplant.
• B. We understand that our child will not be at risk anymore for catching colds from other children at school.
• C. We will be glad that we will not have to bring our child in to see the doctor again.
• D. We know it is important to ensure that our child takes prescribed medications after the transplant.

Correct answer: D

Rationale: The correct answer is D because parents should understand the importance of medication adherence post-transplant to prevent rejection. Following the prescribed medication regimen is crucial for the success of the kidney transplant and the overall health of the child. Monitoring and ensuring the child takes their medications as directed by the healthcare provider are essential components of post-transplant care. Choices A, B, and C are incorrect because they do not address the critical aspect of medication management post-transplant, which is vital for the child's well-being and the success of the procedure.

4. A teacher states to the school nurse, 'I have a student who will often just stare at me for 15 seconds after asking a question; then the student blinks and asks me to repeat the question. Should I be concerned?' Which should the nurse include in the response to the teacher?

• A. The child has a crush on the teacher.
• B. The child has increased intracranial pressure.
• C. The child may have had a head injury.
• D. The child is experiencing absence seizures.

Correct answer: D

Rationale: Staring spells that end abruptly and are followed by normal activity are indicative of absence seizures. In absence seizures, a child may exhibit staring spells, brief loss of awareness, and lack of responsiveness, which can last for a few seconds. Choice A is incorrect because the behavior described is not associated with having a crush. Choice B is incorrect as increased intracranial pressure usually presents with other symptoms. Choice C is less likely as a head injury would typically manifest with additional signs beyond just staring and blinking.

5. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?

• A. 3 months
• B. 2 weeks
• C. 2.6 months
• D. 4 weeks

Correct answer: B

Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.

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