Nursing Elites

1. The mother of an infant diagnosed with bronchiolitis asks the nurse what causes the disease. How should the nurse respond?

• A. Respiratory syncytial virus (RSV)
• B. Haemophilus influenzae
• C. Parainfluenza
• D. Rotavirus

Correct answer: A

Rationale: The correct answer is A: Respiratory syncytial virus (RSV). RSV is the most common cause of bronchiolitis, especially in infants. Bronchiolitis is characterized by inflammation of the small airways in the lungs. Choice B, Haemophilus influenzae, is a bacterium that can cause respiratory infections but is not the primary cause of bronchiolitis. Choice C, Parainfluenza, is a common viral infection that can cause croup and other respiratory illnesses but is not the main cause of bronchiolitis. Choice D, Rotavirus, is a virus that primarily affects the gastrointestinal system, causing diarrhea and vomiting, and is not associated with bronchiolitis.

2. If the needs of the infant are met in a loving, consistent manner, the infant will develop a sense of:

• A. Trust
• B. Love
• C. Independence
• D. Responsibility

Correct answer: A

Rationale: The correct answer is A: Trust. According to Erikson's psychosocial development theory, when infants receive consistent and loving care, they develop trust. This trust forms the basis of the first stage of psychosocial development, known as Trust vs. Mistrust. Trust is essential for healthy social and emotional development. Choice B, Love, is incorrect as it is more of an emotion than a developmental stage. Choice C, Independence, typically occurs later in development during Erikson's Autonomy vs. Shame and Doubt stage. Choice D, Responsibility, is also not the correct answer as it relates more to later stages of development where individuals develop a sense of duty and obligation.

3. An anxious 12-year-old child receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, 'Is it hard to give someone an injection?' This child’s question is evidence that the child has developed which cognitive skill?

• A. Conservation
• B. Accommodation
• C. Decentering
• D. Class inclusion

Correct answer: C

Rationale: The correct answer is C: Decentering. Decentering is the ability to consider multiple aspects of a situation, which the child's question demonstrates. In this scenario, the child's question shows that she is thinking beyond her own experience and considering the difficulty or complexity of giving an injection from the nurse's perspective. Choices A, B, and D are incorrect. Conservation refers to understanding that certain properties of an object remain the same despite changes in its appearance. Accommodation is the process of adjusting existing knowledge or creating new mental categories to incorporate new information. Class inclusion involves understanding the relationship between a whole set and its subsets, which is not demonstrated in the child's question.

4. What is the most critical physiologic change required of newborns at birth?

• A. Transition from fetal to neonatal breathing
• B. Body temperature maintenance
• C. Stabilization of fluid and electrolytes
• D. Closure of fetal shunts in the heart

Correct answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.

5. An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation?

• A. Water excess
• B. Sodium excess
• C. Water depletion
• D. Potassium excess

Correct answer: C

Rationale: These symptoms are indicative of dehydration or water depletion, which is common in infants and can rapidly lead to severe consequences if not addressed promptly.

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