Nursing Elites

1. Which of the following conditions is characterized by a 'machine-like' murmur in children?

• A. Patent ductus arteriosus
• B. Ventricular septal defect
• C. Atrial septal defect
• D. Coarctation of the aorta

Correct answer: A

Rationale: The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.

2. A school-age child with cancer is being prepared for a procedure. The child says, “I have had one of these before. They hurt.” The nurse bases her response on what knowledge related to pain in this patient?

• A. Often misrepresent experiencing pain
• B. Tolerate pain better than adults
• C. Become accustomed to painful procedures
• D. Commonly experience treatment-related moderate to severe pain when they have cancer

Correct answer: D

Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.

3. What signs and symptoms are indicative of a urinary tract disorder in the infancy period (1-24 months)? (Select all that apply.)

• A. All below
• B. Poor feeding
• C. Hypothermia
• D. Frequent urination

Correct answer: A

Rationale: In infants, urinary tract disorders may present with poor feeding, hypothermia, and frequent urination. Pallor can be associated with other conditions but is less specific to urinary tract disorders.

4. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?

• A. S1 and S2
• B. S3 and S4
• C. Murmur
• D. Physiologic splitting

Correct answer: C

Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.

5. The nurse's approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?

• A. The child may think the equipment is alive.
• B. Explaining the equipment will only increase the child’s fear
• C. One brief explanation will be enough to reduce the child’s fear
• D. The child is too young to understand what the equipment does

Correct answer: A

Rationale: Preschoolers may engage in magical thinking and believe inanimate objects are alive, so the nurse should explain the equipment in a way that reduces fear.

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