ExamPlug

1. Nasal flaring in an infant indicates: A. Normal sleep breathing B. Nasal infection only C. An attempt to reduce airway resistance and increase air intake during distress D. Excess sedation Correct Answer: C. An attempt to reduce airway resistance and increase air intake during distress Rationale: Widening the nostrils lowers resistance in the nasal passages, so flaring is a sign of increased work of breathing. It is not normal at rest, is not specific to nasal infection, and does not...

1. Bone age, assessed by a hand and wrist radiograph, is used to: A. Diagnose ear infections B. Measure lung capacity C. Estimate skeletal maturity and remaining growth potential D. Assess vision Correct Answer: C. Estimate skeletal maturity and remaining growth potential Rationale: Comparing bone development with chronological age helps evaluate growth disorders and timing of puberty. It is unrelated to ears, lungs or vision. 2. Girls generally begin their pubertal growth spurt: A. At ...

1. An emancipated minor is: A. Any 16-year-old B. A minor who disagrees with parents C. A minor in foster care D. A minor legally freed from parental control who can consent to his or her own care Correct Answer: D. A minor legally freed from parental control who can consent to his or her own care Rationale: Emancipation, through means such as marriage, military service or court order, gives legal decision-making rights. Age alone, disagreement or foster care do not confer emancipation....

1. Head circumference is measured at well-child visits in the first years of life because it reflects: A. Lung growth B. Bone age C. Brain growth D. Muscle strength Correct Answer: C. Brain growth Rationale: Rapid brain growth in infancy drives head size, so abnormal head growth may indicate hydrocephalus, microcephaly or other problems. It does not measure lungs, bone age or muscles. 2. Measuring the length of a child under 2 years should be done: A. Standing against a wall B. Lying ...

1. The first primary teeth usually erupt at about: A. Birth B. 18 months of age C. 6 months of age D. 3 years of age Correct Answer: C. 6 months of age Rationale: The lower central incisors usually appear around 6 months, with a normal range of about 4 to 12 months. Teeth at birth are uncommon, and no teeth by 18 months warrants evaluation. 2. Mid-parental height is used to: A. Measure head circumference B. Determine bone age C. Calculate BMI D. Estimate a child's genetic target ...

1. Growth in height during the preschool and school-age years averages about: A. 25 cm per year B. 1 cm per year C. 5 to 7.5 cm (2 to 3 inches) per year D. 15 cm per month Correct Answer: C. 5 to 7.5 cm (2 to 3 inches) per year Rationale: After the rapid infant years, children grow steadily about 5 to 7.5 cm yearly until the pubertal spurt. Twenty-five cm reflects the first year, and the other rates are inaccurate. 2. Brain growth in early childhood is so rapid that by about age 2 the br...

1. Cultural humility in palliative care involves: A. Assuming all members of a culture have the same beliefs B. Ignoring cultural factors C. Applying one's own values to all patients D. Ongoing self-reflection and learning from each patient about their beliefs and preferences Correct Answer: D. Ongoing self-reflection and learning from each patient about their beliefs and preferences Rationale: Each patient's preferences may differ from cultural generalizations. Humility and curios...

1. Physical restraints in a delirious patient: A. Are the first-line treatment B. Should be avoided because they increase agitation, injury and distress C. Calm the patient D. Prevent all falls Correct Answer: B. Should be avoided because they increase agitation, injury and distress Rationale: Restraints worsen delirium and can cause harm. Close observation and addressing causes are preferred. 2. Mirtazapine may be a helpful antidepressant in palliative care because it can also: A. Impr...

1. A common barrier to timely palliative care referral is: A. Too many palliative specialists B. The misconception that palliative care is only for the dying or means giving up C. Patients requesting too much information D. Excessive funding Correct Answer: B. The misconception that palliative care is only for the dying or means giving up Rationale: Many patients and clinicians equate palliative care with hospice. Education about its role improves earlier referral. 2. The CAPC (Center t...

1. Palliative care is best described as: A. Care provided only in the last days of life B. Care that requires stopping all curative treatment C. Care limited to patients with cancer D. Specialized care focused on relieving suffering and improving quality of life for people with serious illness, at any stage and alongside curative treatment Correct Answer: D. Specialized care focused on relieving suffering and improving quality of life for people with serious illness, at any stage and alon...

1. The "invitation" step of SPIKES involves: A. Asking how much information the patient wants to know B. Inviting the media C. Inviting all relatives without consent D. Inviting the patient to leave Correct Answer: A. Asking how much information the patient wants to know Rationale: Patients vary in how much detail they want, and respecting this preference is important. Including family requires the patient's permission. 2. A Do Not Resuscitate (DNR) order means: A. No treatment...

1. A nurse uses knowledge of hypertension management and the patient's values to decide, with the team, on the best plan. This represents: A. Data B. Information C. Data entry D. Wisdom Correct Answer: D. Wisdom Rationale: Wisdom is the appropriate application of knowledge to manage and solve human problems. Data and information are earlier levels, and data entry is a task, not a level of the framework. 2. The Nursing Informatics Competencies are often grouped into: A. Computer ski...

1. A key difference between information technology and informatics is that informatics: A. Is only about hardware B. Is unrelated to data C. Focuses on using information and technology to improve outcomes in a specific domain such as nursing D. Avoids clinical work Correct Answer: C. Focuses on using information and technology to improve outcomes in a specific domain such as nursing Rationale: Informatics applies information science to a discipline's goals, while IT focuses on techni...

1. Data conversion or migration in a new system implementation involves: A. Deleting all old data B. Transferring existing data, such as allergies and problem lists, from the old system to the new system accurately C. Printing all records D. Changing patients' names Correct Answer: B. Transferring existing data, such as allergies and problem lists, from the old system to the new system accurately Rationale: Accurate migration ensures continuity and safety. Deleting data or altering id...

1. The Standards of Practice for nursing informatics follow a process similar to: A. A recipe B. A sports playbook C. The nursing process, including assessment, identification of issues, planning, implementation and evaluation D. A legal trial Correct Answer: C. The nursing process, including assessment, identification of issues, planning, implementation and evaluation Rationale: Informatics nurses apply a systematic, nursing process-based approach to problems and projects. The other an...

1. Nursing informatics supports the Quadruple Aim by: A. Improving patient experience, population health, cost and clinician well-being B. Focusing only on cost C. Increasing clinician burnout D. Ignoring patient experience Correct Answer: A. Improving patient experience, population health, cost and clinician well-being Rationale: Well-designed systems can improve all four aims, including reducing clinician burden. Focusing only on cost or increasing burnout contradicts the aim. 2. Lewi...

1. Electronic prescribing of controlled substances (EPCS) requires: A. No identification B. Additional security such as two-factor authentication for prescribers C. Prescriptions sent by personal text message D. Paper backup copies for all orders Correct Answer: B. Additional security such as two-factor authentication for prescribers Rationale: DEA rules require identity proofing and two-factor authentication to prevent diversion. Texting and lack of identification are not permitted. 2. ...

1. The current edition of the ANA Nursing Informatics: Scope and Standards of Practice is the: A. First edition, published in 1980 B. Fifth edition, published in 2030 C. Third edition, published in 2022 D. No formal standards exist Correct Answer: C. Third edition, published in 2022 Rationale: The third edition updated the specialty's scope, competencies and standards. Earlier editions were published in 2008 and 2015, and formal standards do exist. 2. The data-information-knowledge-wi...

1. Apical heart rate in a newborn is auscultated: A. At the radial pulse for 15 seconds B. At the neck only C. Over the abdomen D. For a full minute at the point of maximal impulse, about the fourth intercostal space left of the sternum Correct Answer: D. For a full minute at the point of maximal impulse, about the fourth intercostal space left of the sternum Rationale: The apical pulse is most accurate in newborns, and a full minute captures irregularities. Radial pulses are difficult ...

1. Delayed cord clamping in a term newborn increases: A. Placental transfusion, improving iron stores and blood volume B. The risk of hypothermia in all cases C. Rates of cerebral palsy D. Lung fluid Correct Answer: A. Placental transfusion, improving iron stores and blood volume Rationale: Additional blood from the placenta improves iron status in infancy and supports transition. It may modestly increase jaundice but does not cause cerebral palsy. 2. The umbilical cord normally contains...