Nursing Elites

1. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)

• A. Lightly brush the palate with a cotton swab
• B. Perform the examination in front of a mirror
• C. Let the child examine someone else's mouth first
• D. All of the above

Correct answer: D

Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.

2. What clinical manifestation should be the most suggestive of acute appendicitis?

• A. Rebound tenderness
• B. Bright red or dark red rectal bleeding
• C. Abdominal pain that is relieved by eating
• D. Colicky, cramping abdominal pain around the umbilicus

Correct answer: D

Rationale: The correct answer is D: Colicky, cramping abdominal pain around the umbilicus. This type of pain is a common early sign of acute appendicitis. Rebound tenderness, choice A, is a later sign seen in the physical examination of a patient with appendicitis. Rectal bleeding, as described in choice B, is not typically associated with appendicitis. Abdominal pain that is relieved by eating, as mentioned in choice C, is more indicative of peptic ulcer disease rather than appendicitis.

3. The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

• A. Hamburger patty with no bun
• B. Spaghetti with marinara sauce
• C. Corn on the cob with butter
• D. Rice cakes with hummus

Correct answer: C

Rationale: The correct answer is C: Corn on the cob with butter. Corn is a gluten-free option suitable for children with celiac disease. Choice A is incorrect because the bun contains gluten, so suggesting a hamburger patty without the bun is a better option. Choice B is not ideal as spaghetti often contains gluten, but spaghetti with marinara sauce could be a safer choice if the spaghetti is gluten-free. Choice D, rice cakes with hummus, is a gluten-free alternative, but corn on the cob is a more straightforward and common choice for children.

4. What is the most common cause of abdominal pain in school-aged children?

• A. Gastroenteritis
• B. Constipation
• C. Appendicitis
• D. Irritable bowel syndrome

Correct answer: B

Rationale: Constipation is the most common cause of abdominal pain in school-aged children. It is often due to dietary factors such as low fiber intake or insufficient fluid consumption. Chronic constipation can lead to complications like fecal impaction and soiling, highlighting the importance of early recognition and treatment. Gastroenteritis, although common, typically presents with diarrhea and vomiting. Appendicitis is more common in adolescents and typically presents with right lower quadrant pain. Irritable bowel syndrome is less common in children and is characterized by recurrent abdominal pain associated with defecation.

5. The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?

• A. Ask her, "Are you sexually active?"
• B. Ask her, "Are you having sex with anyone?"
• C. Ask her, "Are you having sex with a boyfriend?"
• D. Ask both the girl and her parent if she is sexually active

Correct answer: A

Rationale: Directly asking the adolescent if she is sexually active is the most straightforward and respectful approach, ensuring privacy and fostering trust.

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