Nokea
What is the first sign of puberty in boys?
- A. Enlargement of testes
- B. Decreased levels of testosterone
- C. Voice deepening
- D. Pubic hair
Correct Answer: A
Rationale: The first sign of puberty in boys is typically the enlargement of the testes. This is due to the increase in production of testosterone, which leads to physical changes such as growth of the testes. Choice B, decreased levels of testosterone, is incorrect as puberty is marked by an increase in testosterone levels. Choice C, voice deepening, and choice D, pubic hair growth, usually occur later in the puberty process compared to testicular enlargement, making them incorrect answers.
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An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?
- A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
- B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
- C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
- D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.
Correct Answer: D
Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.
The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?
- A. Heat only 10 oz or more.
- B. Do not thaw or heat breast milk in a microwave oven.
- C. Always leave the bottle top uncovered to allow heat to escape.
- D. Shake the bottle vigorously for at least 30 seconds after heating.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?
- A. Restlessness
- B. Distractibility
- C. Rectal discharge
- D. Intense perianal itching
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which type of play would be most beneficial for preparing a preschool-age child for upcoming surgery to reduce the stress of the event?
- A. Cooperative play
- B. Associative play
- C. Dramatic play
- D. Onlooker play
Correct Answer: C
Rationale: Dramatic play involves role-playing, allowing children to act out scenarios and become more comfortable with them. This type of play can help reduce anxiety about upcoming events like surgery. Cooperative play involves working together towards a common goal, associative play involves loosely interacting with others, and onlooker play involves observing others play without actively participating. These types of play are not as directly related to preparing a child for surgery and reducing stress as dramatic play.
At which age do most infants begin to fear strangers?
- A. 2 months
- B. 4 months
- C. 6 months
- D. 12 months
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.