Nursing Elites

1. What is an important consideration in understanding the reactions of parents when their infant is born with physical defects?

• A. Grief lasts until the defects are repaired.
• B. Denial is a common adaptive reaction.
• C. The psychologic reaction is similar to that with the death of an infant.
• D. Reactions of health professionals to the birth of an infant can affect parents’ reactions.

Correct answer: C

Rationale: When a parent's infant is born with physical defects, understanding the psychological reactions is crucial. The reaction is often similar to the grief experienced when facing the death of a child. Parents need to grieve for the loss of the expected child and adapt to the needs of a child with physical defects. The grief process typically involves stages like shock, frustration, and anger, which can last for years. Denial during the shock phase is not maladaptive but can help parents cope initially. Additionally, parents are sensitive to the behavior of health professionals, whose interactions can significantly influence the parents' reactions to the infant. Therefore, recognizing the similarity of the psychological reaction to grief is an important consideration in understanding how parents cope with their infant's physical defects.

2. The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?

• A. Physiologic manifestations of renal disease
• B. The fact that adolescents have few coping mechanisms
• C. Neurologic manifestations that occur with dialysis
• D. Resentment of the control and enforced dependence imposed by dialysis

Correct answer: D

Rationale: Adolescents may feel anger and depression due to the loss of independence and control over their lives, which is imposed by the need for regular dialysis treatments. This reaction is common as they struggle with the restrictions placed on their social and personal lives.

3. What is the most effective way to prevent the spread of hand, foot, and mouth disease in a daycare setting?

• A. Handwashing
• B. Isolating sick children
• C. Disinfecting toys
• D. Encouraging vaccination

Correct answer: A

Rationale: Handwashing is indeed the most effective way to prevent the spread of hand, foot, and mouth disease in children. Proper hand hygiene helps in removing and killing germs that can cause infections. While isolating sick children and disinfecting toys are important measures to prevent the spread of diseases, they are not as effective as handwashing. Encouraging vaccination, in this case, is not relevant since there is no specific vaccine available for hand, foot, and mouth disease.

4. A four-year-old boy is admitted to the hospital with leg pain and fever. He is pale-looking and has bruises over various areas of his body. The physician suspects acute lymphoblastic leukemia (ALL). Which test would be used to confirm the diagnosis?

• A. Bone marrow aspirate
• B. Red blood cell count
• C. Lumbar puncture
• D. Bone scan

Correct answer: A

Rationale: A bone marrow aspirate is the definitive test to confirm acute lymphoblastic leukemia (ALL) in this case. It allows for the examination of leukemic cells in the bone marrow, providing a direct assessment of the disease. Red blood cell count (Choice B) is not specific for diagnosing leukemia but may show anemia commonly seen in leukemia patients. Lumbar puncture (Choice C) is used to assess central nervous system involvement, not primarily for confirming ALL. Bone scan (Choice D) is not a standard diagnostic test for ALL and is mainly used for evaluating bone metastases in other conditions.

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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