Nursing Elites

1. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?

• A. Respond to name
• B. React to loud noise with Moro reflex
• C. Turn his or her head to side when sound is at ear level
• D. Locate sound by turning his or her head in a curving arc

Correct answer: B

Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.

2. The nurse is reviewing the importance of role learning for children. The nurse understands that children's roles are primarily shaped by which members?

• A. Peers
• B. Parents
• C. Siblings
• D. Grandparents

Correct answer: B

Rationale: Parents play the primary role in shaping their children's roles and behaviors, especially in early childhood, through modeling, guidance, and expectations.

3. The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?

• A. Pain is common.
• B. Weight loss is severe.
• C. All are correct.
• D. Diarrhea is moderate to severe.

Correct answer: C

Rationale: The correct answer is C because Crohn's disease commonly presents with pain, severe weight loss, and moderate to severe diarrhea in affected individuals. Therefore, all the manifestations listed are typically observed in patients with Crohn's disease. Choice A alone is not sufficient as weight loss and diarrhea are also prominent symptoms. Choice B is incorrect as it only mentions weight loss, omitting other common manifestations. Choice D is also incorrect as it does not cover the full range of expected clinical signs in Crohn's disease.

4. What clinical manifestation(s) should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

• A. Thirst
• B. Irritability
• C. Apprehension
• D. Confusion and somnolence

Correct answer: D

Rationale: As shock progresses and decompensation occurs, confusion and somnolence are indicative of reduced cerebral perfusion. Early signs include thirst and irritability, while confusion and altered consciousness appear as the condition worsens.

5. What is an important priority in dealing with the child suspected of having Wilms tumor?

• A. Intervening to minimize bleeding
• B. Monitoring temperature for infection
• C. Ensuring the abdomen is protected from palpation
• D. Teaching parents how to manage parenteral nutrition

Correct answer: C

Rationale: The correct priority in dealing with a child suspected of having Wilms tumor is ensuring the abdomen is protected from palpation. Palpating the abdomen could lead to tumor dissemination, which is crucial to prevent the spread of cancerous cells. Intervening to minimize bleeding, monitoring temperature for infection, and teaching parents how to manage parenteral nutrition are not the immediate priorities in suspected cases of Wilms tumor.

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