Nursing Elites

1. What is the most consistent and commonly used indicator of pain in infants?

• A. Increased respirations
• B. Increased heart rate
• C. Thrashing of arms and legs
• D. Facial expression of discomfort

Correct answer: D

Rationale: Facial expression has consistently been validated as an indicator of pain in infants. Behavioral pain measures are most reliable for sharp procedural pain in infants. Increased heart rate and respirations are indicative of a generalized and complex response to stress, not specific for pain in infants. Thrashing of arms and legs is a reliable indicator in young children, not specifically in infants.

2. Which factor is most likely to cause a "brittle" diabetic state in a child with type 1 diabetes?

• A. Noncompliance with diet
• B. Insulin resistance
• C. Frequent infections
• D. Hypothyroidism

Correct answer: C

Rationale: Frequent infections can destabilize blood sugar levels, leading to a "brittle" diabetic state in children with type 1 diabetes. Infections increase metabolic demands and can result in significant blood glucose fluctuations, requiring careful monitoring and adjustment of insulin therapy. Noncompliance with diet may affect blood sugar control but is not the primary cause of a "brittle" state. Insulin resistance is more common in type 2 diabetes rather than type 1. Hypothyroidism can impact metabolism but is not directly linked to the development of a "brittle" diabetic state in type 1 diabetes.

3. What is a common cause of acquired aplastic anemia in children?

• A. Deficient diet
• B. Ingestion of drugs such as chloramphenicol or antiepileptics
• C. Congenital defects
• D. Injury

Correct answer: B

Rationale: The correct answer is B. Acquired aplastic anemia in children is often caused by exposure to certain drugs, such as chloramphenicol or antiepileptics, which can lead to bone marrow failure and a decrease in all types of blood cells. Choices A, C, and D are incorrect because aplastic anemia is not commonly caused by deficient diet, congenital defects, or injury in children.

4. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?

• A. A normal finding
• B. A sign of a possible visual defect and a need for vision screening
• C. An abnormal finding requiring referral to an ophthalmologist
• D. A sign of small hemorrhages, which usually resolve spontaneously

Correct answer: A

Rationale: A brilliant, uniform red reflex in both eyes is a normal finding, indicating that the retina is healthy and there are no significant obstructions in the visual pathway.

5. An important intervention for infants with developmental disabilities is to:

• A. Help parents realize their child will not develop further
• B. Stress the importance of early infant stimulation and intervention programs
• C. Have them institutionalized as soon as possible
• D. Have children reevaluated at 2 years of age to confirm the diagnosis

Correct answer: B

Rationale: The correct answer is B: Stress the importance of early infant stimulation and intervention programs. Early intervention programs are essential for infants with developmental disabilities as they can significantly impact the child's development and future outcomes. These programs provide necessary support and therapies to enhance the child's skills and abilities. Choice A is incorrect because it is crucial to provide hope and support to parents, emphasizing the potential for development and progress. Choice C is inappropriate and unethical as the first line of intervention. Institutionalization should only be considered in extreme cases where other options have been exhausted. Choice D is not the most crucial intervention at this stage. While reevaluation may be necessary, early intervention and support should be prioritized to maximize the child's developmental potential.

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