Nursing Elites

1. The LPN is assessing for fontanels on the head of a 6-month-old. Which fontanel is expected to still be present?

• A. Posterior
• B. Anterior
• C. Sphenoid
• D. Lambdoid

Correct answer: B

Rationale: The correct answer is B: Anterior. The anterior fontanel usually remains open until about 12-18 months of age, while the posterior fontanel closes by 2-3 months. Choices A, C, and D are incorrect as the posterior fontanel closes by 2-3 months of age, and the sphenoid and lambdoid fontanels are not typically assessed in routine infant head examinations.

2. 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.

3. A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?

• A. Pizza
• B. Pretzels
• C. Popcorn
• D. Oatmeal cookies

Correct answer: C

Rationale: Popcorn is a safe snack for a child with celiac disease as it is naturally gluten-free. Other options like pizza, pretzels, and oatmeal cookies typically contain gluten unless specifically made with gluten-free ingredients, which can exacerbate celiac symptoms. Therefore, popcorn is the best option to suggest to the child to avoid any adverse effects on their condition.

4. What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

• A. All below
• B. Poor feeding
• C. Hypothermia
• D. Frequent urination

Correct answer: A

Rationale: In infants, urinary tract disorders may present with poor feeding, hypothermia, and frequent urination. Pallor can be associated with other conditions but is less specific to urinary tract disorders.

5. A 14-year-old with chronic renal failure suddenly becomes non-compliant with the medication regimen. Which nursing intervention would most likely improve compliance?

• A. Give the child a computer-animated game that presents information on the management of chronic renal failure.
• B. Set up a meeting with some older teens who have chronic renal failure and have been managing their disease effectively.
• C. Arrange for a physician to sit down and talk to the child about the risks related to noncompliance with medications.
• D. Discuss with the child’s parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.

Correct answer: B

Rationale: Adolescents often seek guidance and support from their peers. Setting up a meeting with older teens who are effectively managing chronic renal failure can provide the 14-year-old with motivation, encouragement, and practical advice on how to handle their treatment regimen. This peer support can positively influence the non-compliant adolescent, making choice B the most likely intervention to improve compliance. Choices A and C may not address the peer influence aspect of adolescent behavior, while choice D focuses on punitive measures rather than addressing the underlying reasons for non-compliance.

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