Nursing Elites

1. Parents would suspect hearing loss if their child did not:

• A. Turn away from a sound
• B. Startle with sudden loud noises immediately after birth
• C. Talk at 4 months
• D. Babble at 2 months

Correct answer: D

Rationale: The correct answer is D because babbling is an early indicator of hearing ability in infants. Lack of babbling by 2 months may suggest a potential hearing issue. Choices A, B, and C are incorrect because turning away from a sound, startling with sudden loud noises immediately after birth, and talking at 4 months are not primary indicators of hearing loss in infants.

2. A child with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention should be included in the plan of care?

• A. Monitor blood pressure every 30 minutes.
• B. Reposition the child every two hours.
• C. Limit visitors.
• D. Encourage fluids.

Correct answer: B

Rationale: Repositioning the child every two hours is essential to prevent pressure ulcers and promote circulation, especially when the child is on bed rest and experiencing severe edema. Monitoring blood pressure is important but does not need to be done every 30 minutes unless indicated. Limiting visitors and encouraging fluids are not directly related to managing edema and preventing complications from immobility. Therefore, choice B is the most appropriate nursing intervention in this scenario.

3. A nurse is carrying on a conversation with a 7-year-old child during an office visit. Which is an example of the level of language development the nurse should expect in this child?

• A. Fascination with bathroom language
• B. Difficulty understanding the concept of 'half past' in reference to time
• C. Ability to carry on an adult conversation
• D. Inability to speak in full sentences

Correct answer: B

Rationale: The correct answer is B. Understanding time concepts like 'half past' can be challenging for a 7-year-old, indicating the level of language development. Choice A is incorrect as fascination with bathroom language is common in this age group but not necessarily indicative of language development. Choice C is incorrect as a 7-year-old typically cannot carry on an adult conversation due to cognitive and experiential limitations. Choice D is incorrect as by the age of 7, children should be able to speak in full sentences.

4. What laboratory finding should the nurse expect in a child with an excess of water?

• A. Decreased hematocrit
• B. High serum osmolality
• C. High urine specific gravity
• D. Increased blood urea nitrogen (BUN)

Correct answer: A

Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.

5. What is the most appropriate intervention for a child with suspected acute appendicitis?

• A. Administer antibiotics
• B. Apply heat to the abdomen
• C. Encourage oral fluids
• D. Prepare for surgery

Correct answer: D

Rationale: The correct answer is D: Prepare for surgery. Acute appendicitis is a surgical emergency that requires prompt removal of the appendix to prevent complications like rupture and peritonitis. Administering antibiotics (choice A) may be part of the treatment plan but should not delay surgical intervention. Applying heat to the abdomen (choice B) is not recommended as it can worsen the inflammation of the appendix. Encouraging oral fluids (choice C) is generally beneficial, but the priority in acute appendicitis is surgical intervention.

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