Nursing Elites

1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?

• A. The United States is ranked last among 27 countries
• B. The United States is ranked similar to 20 other developed countries
• C. The United States is ranked in the middle of 20 other developed countries
• D. The United States is ranked highest among 27 other industrialized countries

Correct answer: A

Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.

2. Which situation denotes a nontherapeutic nurse-patient-family relationship?

• A. The nurse is planning to read a favorite fairy tale to a patient
• B. During shift report, the nurse is criticizing parents for not visiting their child
• C. The nurse is discussing with a fellow nurse the emotional draw to a certain patient
• D. The nurse is working with a family to find ways to decrease the family’s dependence on health care providers

Correct answer: B

Rationale: Criticizing parents or making negative comments about their involvement is nontherapeutic and can damage the nurse-patient-family relationship.

3. When a pre-school child says the sun shines to keep her warm, this is an example of:

• A. Animism
• B. Artificialism
• C. Egocentrism
• D. Centering

Correct answer: B

Rationale: The correct answer is B: Artificialism. Artificialism is the belief that natural phenomena are created by human beings for human purposes. In this scenario, the child attributes human-like intentions to the sun, assuming it shines specifically to keep her warm. Choice A, Animism, is the belief that natural objects and phenomena are alive and have feelings. Choice C, Egocentrism, refers to a child's difficulty in seeing things from another person's perspective. Choice D, Centering, involves focusing on only one aspect of a situation while ignoring other relevant aspects.

4. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action?

• A. Ask the parent when the neck was injured
• B. Refer for immediate medical evaluation
• C. Continue assessment to determine the cause of the neck pain
• D. Record head lag on the assessment record and continue the assessment of the child

Correct answer: B

Rationale: Opisthotonos with pain on flexion is a sign of possible meningitis or other serious neurological conditions, requiring immediate medical evaluation.

5. What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?

• A. Hold feedings.
• B. Check gastric residuals before feedings.
• C. Take rectal temperature.
• D. Closely monitor abdominal distention.

Correct answer: D

Rationale: The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.

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