Nursing Elites

1. When assessing a child with a possible fracture, what would be the most reliable indicator for the nurse to identify?

• A. Lack of spontaneous movement
• B. Point tenderness
• C. Bruising
• D. Inability to bear weight

Correct answer: B

Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It refers to localized pain at a specific point, indicating a potential bone injury. Lack of spontaneous movement (Choice A) is non-specific and can be due to various reasons. Bruising (Choice C) may be present in fractures but is not as specific as point tenderness. Inability to bear weight (Choice D) can also be seen in fractures but may not always be present, making it less reliable compared to point tenderness.

2. A 5-year-old child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial for managing asthma symptoms as certain foods can trigger or worsen asthma attacks. Monitoring dietary intake helps ensure the child receives proper nutrition and avoids triggers. Assessing sleep patterns (Choice A) may be relevant but not as directly impactful on asthma management. Academic performance (Choice C) and behavior at home (Choice D) are important aspects of a child's overall health but are not as directly related to asthma management as dietary intake.

3. When obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism, what would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: In congenital hypothyroidism, infants often experience lethargy and difficulty staying awake due to low thyroid hormone levels. Choice A is incorrect as hypothyroidism can lead to poor growth in infants. Choice B is incorrect because hypothyroidism can cause decreased activity levels and lethargy rather than being active and playful. Choice C is incorrect as hypothyroidism can result in dry skin and poor skin tone, not necessarily pink and healthy-looking skin.

4. A group of students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The primary function of the endocrine system is hormonal secretion. This system is responsible for producing and releasing hormones that regulate various bodily functions such as growth, metabolism, and mood. Choice A, regulation of water balance, is more related to the functions of the renal system rather than the endocrine system. Choice C, cellular metabolism, is a general cellular process that involves various systems, not specific to the endocrine system. Choice D, growth stimulation, though hormones can influence growth, it is not the primary function of the endocrine system. Therefore, the correct answer is B.

5. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include

• A. Oxygen, uterine massage, and transport
• B. Oxygen, placement on the left side, and transport
• C. Oxygen, treatment for shock, and uterine massage during transport
• D. Oxygen, internal vaginal pads, and treatment for shock during transport

Correct answer: C

Rationale: In this scenario, the 21-year-old mother is showing signs of hemorrhagic shock with increased heart rate, diaphoresis, and vaginal bleeding. The appropriate management includes providing oxygen to support tissue perfusion, treating for shock to restore adequate circulation, and performing uterine massage to help control bleeding during transport. Options A, B, and D do not address the comprehensive management needed for postpartum hemorrhage in this situation.

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