Nursing Elites

1. 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.

2. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

• A. Focus communication on the child.
• B. Use easy analogies when possible.
• C. Explain experiences of others to the child
• D. Assure the child that communication is private

Correct answer: A

Rationale: Focusing communication directly on the child aligns with their egocentric nature and helps engage them in the conversation.

3. The parent of a 3-month-old infant is concerned because the infant is not able to sit independently. How should the nurse respond to this parent's concern?

• A. Sitting ability and the age of first tooth eruption are not correlated.
• B. Most infants sit steadily at 4 months.
• C. Most infants sit steadily at 3 months.
• D. Most infants do not sit steadily until 6-8 months.

Correct answer: D

Rationale: The correct answer is D because sitting steadily typically occurs closer to 6-8 months of age, not 3 or 4 months. Choice A is incorrect because sitting ability and the age of first tooth eruption are not related. Choice B and C are incorrect as most infants do not sit steadily at 3 or 4 months, and it is more common for infants to achieve this milestone around 6-8 months.

4. A nurse is carrying on a conversation with a 7-year-old child during an office visit. Which is an example of the level of language development the nurse should expect in this child?

• A. Fascination with bathroom language
• B. Difficulty understanding the concept of 'half past' in reference to time
• C. Ability to carry on an adult conversation
• D. Inability to speak in full sentences

Correct answer: B

Rationale: The correct answer is B. Understanding time concepts like 'half past' can be challenging for a 7-year-old, indicating the level of language development. Choice A is incorrect as fascination with bathroom language is common in this age group but not necessarily indicative of language development. Choice C is incorrect as a 7-year-old typically cannot carry on an adult conversation due to cognitive and experiential limitations. Choice D is incorrect as by the age of 7, children should be able to speak in full sentences.

5. 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.

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