Nursing Elites

1. Before starting kindergarten, the child should receive boosters of which primary immunizations to ensure ongoing protection?

• A. IPV, HepB, Td.
• B. DTaP, HepB, Td.
• C. MMR, DTaP, Hib.
• D. DTaP, IPV, MMR.

Correct answer: D

Rationale: Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR. DTaP provides protection against diphtheria, tetanus, and pertussis, IPV protects against polio, and MMR immunization covers measles, mumps, and rubella. These boosters are essential to maintain immunity and protect the child from these diseases as they enter school. Choices A, B, and C are incorrect because they do not include the recommended boosters for kindergarten entry and may leave the child susceptible to certain infections.

2. What finding would lead healthcare providers to suspect Turner syndrome in a child?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.

3. A healthcare provider is discussing the care of an infant with colic with the parents. What should the healthcare provider explain is the cause of colicky behavior?

• A. Inadequate peristalsis
• B. Paroxysmal abdominal pain
• C. An allergic response to certain proteins in milk
• D. A protective mechanism designed to eliminate foreign proteins

Correct answer: B

Rationale: Colicky behavior in infants is primarily characterized by paroxysmal abdominal pain, resulting in excessive crying and fussiness. The pain episodes are often unpredictable and can be distressing for both the infant and the parents. Inadequate peristalsis (Choice A) refers to weak or ineffective bowel movements and is not the typical cause of colic. While some infants may experience colic due to an allergic response to certain proteins in milk (Choice C), this is not the primary cause of colic behavior in all infants. Choice D, a protective mechanism designed to eliminate foreign proteins, is not a recognized cause of colic. Therefore, the correct explanation for the cause of colicky behavior in infants is paroxysmal abdominal pain.

4. A 7-month-old girl is to be catheterized to obtain a sterile urine specimen. One of the infant’s parents expresses fear that this procedure may traumatize the baby psychologically. How should the nurse provide reassurance?

• A. The fear is justified and the nurse should obtain a “clean catch” specimen.
• B. Parents have a right to refuse the catheterization and the concerns are realistic.
• C. Although the concern is appropriate, the need for a sterile specimen is the priority.
• D. The procedure is uncomfortable, but there should not be a damaging long-term effect.

Correct answer: D

Rationale: While catheterization can be uncomfortable, it does not typically result in long-term psychological harm, and obtaining a sterile specimen is important for accurate diagnosis.

5. During a physical examination of a 9-month-old baby, the nurse observes a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule.
• B. Macule.
• C. Vesicle.
• D. Scale.

Correct answer: B

Rationale: The correct answer is B: Macule. A macule is a flat, discolored area on the skin that is smaller than 1 cm in diameter. This term is used to describe conditions like freckles or petechiae. Choice A, Papule, refers to a small, solid, raised skin lesion (<0.5 cm) like a pimple. Choice C, Vesicle, describes a small blister filled with clear fluid. Choice D, Scale, refers to flakes or plates of dead skin that may be dry or greasy.

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