Nursing Elites

1. When reviewing developmental changes with the parents of a 6-month-old infant, what information should the practical nurse reinforce?

• A. Encourage the infant to self-feed finger foods.
• B. Teach the parents strategies to help the infant sit up.
• C. Provide a developmentally safe environment for the infant.
• D. Explain that an increased appetite typically occurs in the next 6 months.

Correct answer: C

Rationale: The correct answer is C because providing a developmentally safe environment for a 6-month-old infant is crucial as they begin to explore their surroundings more actively. This includes ensuring that the environment is free of hazards and that the infant is supervised to prevent accidents. Choice A is incorrect because self-feeding finger foods may not be developmentally appropriate for a 6-month-old infant. Choice B is incorrect as most infants are able to sit up with support around 6 months of age without the need for specific teaching strategies. Choice D is also incorrect as while appetite changes can occur, explaining a specific increase in appetite over the next 6 months is not a primary focus when discussing developmental changes with parents of a 6-month-old.

2. An adolescent female who comes to the school clinic is reluctant to confide her concerns to the practical nurse (PN). The PN tells the teen that confidentiality and privacy are maintained unless a life-threatening situation arises. Which principle supports the PN's response?

• A. The adolescent should be encouraged to seek help outside of the school clinic.
• B. Disclosures from the adolescent should be kept confidential.
• C. Honest information ensures establishing a trusting relationship.
• D. Minor adolescents should not be encouraged to disclose private concerns.

Correct answer: C

Rationale: The correct principle supporting the practical nurse's response is that honest information ensures establishing a trusting relationship. By assuring confidentiality and privacy to the adolescent unless there is a life-threatening situation, the practical nurse fosters an environment where the teen feels safe to share their concerns openly. This approach helps build trust, encouraging effective communication and support for the adolescent's well-being. Choices A, B, and D are incorrect because encouraging seeking help outside the school clinic, keeping disclosures confidential, and discouraging minor adolescents from sharing private concerns do not address the immediate need to build trust and ensure the well-being of the adolescent in a school setting.

3. A 9-year-old child with a history of type 1 diabetes is brought to the clinic for a check-up. The nurse notes that the child's hemoglobin A1c is 8.5%. What is the most appropriate action for the nurse to take?

• A. Increase the child’s insulin dose
• B. Review the child’s dietary habits and insulin administration technique
• C. Discuss the possibility of switching to oral hypoglycemics
• D. Schedule a follow-up appointment in three months

Correct answer: B

Rationale: A hemoglobin A1c of 8.5% indicates suboptimal diabetes control. The most appropriate action for the nurse in this scenario is to review the child’s dietary habits and insulin administration technique. This approach can help identify potential areas for improvement and optimize diabetes management, aiming to lower the hemoglobin A1c levels towards the target range. Increasing the child’s insulin dose (Choice A) without addressing dietary habits and administration technique may not lead to better control and can increase the risk of hypoglycemia. Switching to oral hypoglycemics (Choice C) is not appropriate for type 1 diabetes management. Scheduling a follow-up appointment in three months (Choice D) without intervening to improve diabetes control is not the best immediate action.

4. The caregiver is being educated by a healthcare provider about the use of a metered-dose inhaler (MDI) for their 8-year-old child with asthma. Which statement by the caregiver indicates a need for further teaching?

• A. I will shake the inhaler before each use
• B. My child should breathe in quickly after pressing the inhaler
• C. I should wait a minute between puffs
• D. We should use a spacer with the inhaler

Correct answer: B

Rationale: The caregiver should be informed that the child should breathe in slowly and deeply after pressing the inhaler. This allows for better medication delivery to the lungs and ensures optimal effectiveness of the treatment.

5. While teaching a parenting class to new parents, the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors?

• A. Children need help in developing social skills.
• B. This age group fears loss of self-control.
• C. They provide the child with a sense of security.
• D. Children must learn to deal with authority.

Correct answer: C

Rationale: Implementing discipline and limit setting for infants and toddlers is primarily important as it provides them with a sense of security. This sense of security is crucial for their emotional and psychological development, helping them feel safe and supported as they explore the world around them. Choice A is incorrect because while developing social skills is important, the primary reason for discipline and limit setting in this context is to provide security. Choice B is incorrect as it does not address the main reason for implementing discipline and limit setting. Choice D is incorrect as the primary focus is not about dealing with authority at this early stage of development.

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