Nursing Elites

1. Play activities of the preschool-age child include:

• A. Having imaginary playmates
• B. Selective collection of objects
• C. Complex board games
• D. Associative play

Correct answer: A

Rationale: The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.

2. What urine test result is considered abnormal?

• A. pH 4.0
• B. WBC 1 or 2 cells/ml
• C. Protein level absent
• D. Specific gravity 1.020

Correct answer: A

Rationale: A urine pH of 4.0 is abnormally low, indicating possible acidosis or other metabolic conditions. WBC count of 1-2 cells/ml, absence of protein, and a specific gravity of 1.020 are within normal limits.

3. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

• A. At the lacrimal duct
• B. On the sclera while the child looks to the outside
• C. In the conjunctival sac when the lower eyelid is pulled down
• D. Carefully under the eyelid while it is gently pulled upward

Correct answer: C

Rationale: Eye drops should be placed in the conjunctival sac, which allows the medication to be absorbed properly without causing irritation. Placing drops directly on the sclera or near the lacrimal duct is less effective and can cause discomfort.

4. What is the most common cause of acute gastroenteritis in children under 5 years?

• A. Salmonella
• B. Rotavirus
• C. Norovirus
• D. Shigella

Correct answer: B

Rationale: Rotavirus is the leading cause of acute gastroenteritis in children under 5 years. It leads to severe diarrhea and dehydration. Vaccination against rotavirus has significantly reduced the incidence of this disease, but it remains a major cause of morbidity in young children globally. Salmonella and Shigella can cause gastroenteritis, but they are less common in children under 5 years. Norovirus is also a common cause of gastroenteritis, but Rotavirus is the most prevalent in this age group.

5. The parents of a child with sickle cell anemia ask why their child did not have a sickle cell crisis until he was approximately 6 months old. How should the nurse respond?

• A. Your child probably had a crisis, and you were unaware of the symptoms.
• B. Are you sure your child has sickle cell anemia and not sickle cell trait?
• C. Affected children can be asymptomatic in early infancy because of high levels of fetal hemoglobin that inhibit sickling.
• D. Have you asked your doctor about this yet?

Correct answer: C

Rationale: The correct answer is C. Fetal hemoglobin (HbF) is present in high levels during early infancy, inhibiting sickling unlike adult hemoglobin (HbS). As the levels of HbF decrease and HbS increases, the risk of sickling and crises becomes more pronounced, typically after 6 months of age. Choice A is incorrect because it assumes the crisis went unnoticed, which is not supported by medical knowledge. Choice B is incorrect as it questions the child's diagnosis rather than explaining the phenomenon of delayed crises. Choice D is incorrect as it does not provide the parents with the necessary information regarding their query.

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