Nursing Elites

1. The nurse is assessing a 3-year-old child. Which assessment finding would the nurse identify as abnormal?

• A. Pedals tricycle without assistance
• B. Unscrews a bolt on a toy
• C. Falls when bending over to touch toes
• D. Builds a tower of 10 cubes

Correct answer: C

Rationale: The correct answer is C. Falling when bending over to touch toes could indicate a developmental delay or a balance issue that may need further assessment. Choices A, B, and D are typical developmental milestones for a 3-year-old child. Pedaling a tricycle without assistance, unscrewing a bolt on a toy, and building a tower of 10 cubes are all age-appropriate activities for a child of this age.

2. What is the number one leading cause of death in children over 1 year of age?

• A. Congenital anomalies
• B. Homicide
• C. Suicide
• D. Accidents

Correct answer: D

Rationale: Accidents, such as motor vehicle accidents, drowning, and falls, are the primary cause of death in children over 1 year of age. While congenital anomalies can be a significant cause of mortality in infants, they are less common in older children. Homicide and suicide are serious issues but are not as prevalent as accidents in causing death among children over 1 year of age.

3. An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for?

• A. Central venous catheter infection, electrolyte losses, and hyperglycemia
• B. Hypoglycemia, catheter migration, and weight gain
• C. Venous thrombosis, hyperlipidemia, and constipation
• D. Catheter damage, red currant jelly stools, and hypoglycemia

Correct answer: A

Rationale: Infants with short bowel syndrome requiring prolonged total parenteral nutrition (TPN) are susceptible to central venous catheter infections, electrolyte losses, and hyperglycemia. Monitoring for these complications is crucial to prevent serious outcomes. Choices B, C, and D are incorrect because they do not reflect the common complications associated with prolonged TPN in infants.

4. Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

• A. Avoid asking the child to make choices.
• B. Plan for a teaching session to last about 20 minutes.
• C. Demonstrate on a doll how the procedure will be done.
• D. Show the necessary equipment without allowing child to handle it.

Correct answer: C

Rationale: Demonstrating on a doll helps the toddler understand what will happen in a non-threatening way, making the procedure less intimidating. Long teaching sessions or avoiding choices can increase anxiety.

5. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

• A. 1 month
• B. 2 months
• C. 3 months
• D. 4 months

Correct answer: B

Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.

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