Nursing Elites

1. What is the primary force in sex education in a child's life?

• A. school nurse
• B. peers
• C. parents
• D. media

Correct answer: C

Rationale: Parents are the primary force in sex education in a child's life. Parents play a central role in shaping a child's understanding of sex from an early age. They provide continuous guidance, values, and information about sex and relationships. While the school nurse is involved in formal sex education and counseling within the school setting, parents have the most direct and significant impact on a child's sex education. Peers become more influential during adolescence, but their information may not always be accurate or appropriate. The media also exert significant influence on children's perceptions of sex through various forms of entertainment like movies, TV shows, and video games, but parents remain the primary educators on this subject.

2. What are major competencies for the nurse giving end-of-life care?

• A. demonstrating respect and compassion, and applying knowledge and skills in the care of the family and the client.
• B. assessing and intervening to support total management of the family and client.
• C. setting goals, expectations, and dynamic changes to care for the client.
• D. keeping all sad news away from the family and client.

Correct answer: A

Rationale: Major competencies for nurses providing end-of-life care involve a combination of skills and qualities. Demonstrating respect and compassion towards the family and the client is essential in end-of-life care. Additionally, applying knowledge and skills in caring for both the family and the client is crucial to ensure comprehensive and compassionate care. Option A is the correct choice as it accurately reflects these key competencies. Option B, which focuses on assessing and intervening for total management, is important but does not fully address the holistic approach necessary for end-of-life care. Option C, about setting goals and expectations, is relevant but not as critical as the core competencies mentioned in option A. Option D is incorrect as withholding sad news goes against the principles of honesty and transparency in end-of-life care.

3. When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?

• A. family history of stroke
• B. ovaries removed before age 45
• C. frequent hot flashes and/or night sweats
• D. unexplained vaginal bleeding

Correct answer: D

Rationale: When obtaining a health history on a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication for hormone replacement therapy. This is because it can be a sign of underlying issues that need to be addressed before starting hormone therapy. A family history of stroke is not a contraindication for hormone replacement therapy unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 is not a contraindication for hormone replacement therapy. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy; therefore, they are not contraindications.

4. While performing a physical assessment on a 6-month-old infant, the nurse observes head lag. Which of the following nursing actions should the nurse perform first?

• A. Ask the parents to allow the infant to lie on his stomach to promote muscle development.
• B. Notify the physician because a developmental or neurological evaluation is indicated.
• C. Document the findings as abnormal in the nurse's notes.
• D. Explain to the parents that their child is likely to have developmental delays.

Correct answer: B

Rationale: Head lag should be completely resolved by 4 months of age. Continuing head lag at 6 months of age indicates the need for further developmental or neurological evaluation. Laying the infant on his stomach promotes muscle development of the neck and shoulder muscles, but because of the age of this child, a referral should be the first action. The findings are abnormal for a 6-month-old infant. Significant head lag can be seen in infants with Down syndrome and hypoxia, as well as neurological and other metabolic disorders. While some of these disorders might include developmental delays, stating this to the parents without a proper evaluation can cause unnecessary distress. The priority is to identify the cause of the head lag through a medical evaluation before discussing potential outcomes with the parents.

5. At what age are yearly mammograms recommended to start?

• A. Yearly mammograms are recommended starting at age 25.
• B. Yearly mammograms are recommended starting at age 40.
• C. Yearly mammograms are not necessary unless there is a family history of breast cancer.
• D. Yearly mammograms are recommended starting at age 20 and continuing until menopause begins.

Correct answer: B

Rationale: The correct answer is B. The American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. Clinical breast examination should be done about every 3 years for women in their 20s and 30s and every year for women age 40 and older. Women should know how their breasts normally look and feel and report any breast change promptly to the healthcare provider. Breast self-examination should be done monthly starting when a woman is in her 20s. Choice A is incorrect as mammograms are not recommended to start at age 25. Choice C is incorrect as yearly mammograms are still recommended even without a family history of breast cancer. Choice D is incorrect as the recommended age for starting yearly mammograms is 40, not 20.

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