Nursing Elites

1. In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?

• A. Neuroblastoma
• B. Nephroblastoma
• C. Leukemia
• D. Osteosarcoma

Correct answer: A

Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.

2. Which statement regarding bottle mouth caries requires further teaching?

• A. Caries can be decreased by putting an infant to bed with a bottle of milk or sweetened juice
• B. Eliminating the bedtime bottle or substituting water is recommended
• C. Sugar pools within the oral cavity cause severe decay
• D. It is often seen in children between 18 months and 3 years

Correct answer: A

Rationale: The correct answer is A. Putting an infant to bed with a bottle of milk or sweetened juice increases the risk of bottle mouth caries rather than decreasing it. This statement requires further teaching as it provides incorrect information. Choice B is correct as eliminating the bedtime bottle or substituting water is recommended to prevent bottle mouth caries. Choice C is also correct as sugar pooling within the oral cavity can indeed cause severe decay. Choice D is correct as bottle mouth caries is often observed in children between 18 months and 3 years.

3. The nurse is discussing sexually transmitted infections (STIs) with a 17-year-old student. Which cognitive development theory should the teaching plan be based on?

• A. Sensorimotor reactions
• B. Limited cause and effect understanding
• C. Abstract thinking
• D. Concrete thinking

Correct answer: C

Rationale: The correct answer is C: 'Abstract thinking.' According to Piaget’s theory of cognitive development, adolescents, typically around the age of 12 and older, enter the formal operational stage where they can think abstractly and reason about hypothetical situations. When discussing complex topics like STIs with a 17-year-old student, it is essential to base the teaching plan on abstract thinking. Choice A, 'Sensorimotor reactions,' is incorrect as it pertains to the earliest stage in Piaget's theory (birth to 2 years old) focusing on sensory experiences and physical interactions. Choice B, 'Limited cause and effect understanding,' does not align with the cognitive abilities of a 17-year-old who is capable of more advanced thinking. Choice D, 'Concrete thinking,' is also incorrect as it refers to the stage before formal operations, where individuals think more concretely and struggle with abstract concepts.

4. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?

• A. "We will give you your shot when your mommy comes back."
• B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
• C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
• D. "This is a magic sword that will give you your medicine and make you all better."

Correct answer: C

Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.

5. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?

• A. Respond to name
• B. React to loud noise with Moro reflex
• C. Turn his or her head to side when sound is at ear level
• D. Locate sound by turning his or her head in a curving arc

Correct answer: B

Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.

Similar Questions