Nursing Elites

1. What clinical manifestation(s) should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

• A. Thirst
• B. Irritability
• C. Apprehension
• D. Confusion and somnolence

Correct answer: D

Rationale: As shock progresses and decompensation occurs, confusion and somnolence are indicative of reduced cerebral perfusion. Early signs include thirst and irritability, while confusion and altered consciousness appear as the condition worsens.

2. What is the best age to introduce solid food into an infant’s diet?

• A. 2 to 3 months
• B. 4 to 6 months
• C. When birth weight has tripled
• D. When tooth eruption has started

Correct answer: B

Rationale: The introduction of solid foods is recommended at 4 to 6 months when the infant's digestive system is more developed and ready for solids.

3. Which distraction technique should be used for an adolescent child during a painful procedure?

• A. Blowing bubbles
• B. Guided imagery
• C. EMLA cream
• D. Sucrose solution

Correct answer: B

Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.

4. What is typically the first sign of puberty in females?

• A. Breast development
• B. Menarche
• C. Pubic hair growth
• D. Axillary hair growth

Correct answer: A

Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.

5. Which type of play is most appropriate for a hospitalized toddler?

• A. Cooperative play
• B. Parallel play
• C. Competitive play
• D. Solitary play

Correct answer: B

Rationale: The most appropriate type of play for a hospitalized toddler is parallel play. This type of play allows toddlers to engage alongside each other but not directly with each other, which can be comforting and less overwhelming in a hospital setting. Cooperative play (choice A) involves working together towards a common goal, which may be challenging for a hospitalized toddler. Competitive play (choice C) involves a level of rivalry that may not be suitable during a hospital stay. Solitary play (choice D) involves playing alone, which may not provide the social interaction and distraction that parallel play can offer in a hospital environment.

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