Nursing Elites

1. Which muscle is contraindicated for the administration of immunizations in infants and young children?

• A. Deltoid
• B. Dorsogluteal
• C. Ventrogluteal
• D. Anterolateral thigh

Correct answer: B

Rationale: The dorsogluteal muscle is contraindicated for immunizations in infants and young children due to the risk of injury to the sciatic nerve. The anterolateral thigh is the preferred site.

2. 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.

3. The nurse is presenting a staff development program about understanding culture in the healthcare encounter. Which components should the nurse include in the program? (Select all that apply.)

• A. Cultural humility
• B. All are applicable
• C. Cultural sensitivity
• D. Cultural competency

Correct answer: B

Rationale: Cultural humility, sensitivity, and competency are key components in providing culturally competent care in healthcare encounters.

4. Which laboratory test would be most important for the nurse to assess when caring for a toddler suspected of having cystic fibrosis?

• A. Liver enzymes
• B. Serum calcium
• C. Sweat chloride test
• D. Urine creatinine

Correct answer: C

Rationale: The sweat chloride test is the primary diagnostic test for cystic fibrosis. Cystic fibrosis is characterized by abnormal transport of chloride and sodium across epithelial cell membranes, leading to increased chloride in sweat. This test is crucial for diagnosing cystic fibrosis in suspected cases. Liver enzymes (Choice A), serum calcium (Choice B), and urine creatinine (Choice D) are not specific tests for cystic fibrosis and would not provide the necessary information for diagnosis in this case.

5. An infant, age 6 months, has six teeth. The nurse should recognize that this is what?

• A. Normal tooth eruption
• B. Delayed tooth eruption
• C. Unusual and dangerous
• D. Earlier than expected tooth eruption

Correct answer: D

Rationale: Having six teeth at 6 months is earlier than the typical tooth eruption schedule, but it is not unusual or dangerous. It is within the range of normal variations in infant development.

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