Nursing Elites

1. When should a mother introduce solid foods to her 4-month-old baby girl? The mother states, 'My mother says I should put rice cereal in the baby's bottle now.' The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?

• A. Stops rooting when hungry
• B. Opens mouth when food comes her way
• C. Awakens once for nighttime feedings
• D. Gives up a bottle for a cup

Correct answer: B

Rationale: The correct answer is B: 'Opens mouth when food comes her way.' This behavior indicates readiness to start trying solid foods. Infants should be introduced to solid foods based on developmental cues, such as showing an interest in food and the ability to accept it. Choices A, C, and D are not indicative of readiness for solid foods. Stopping rooting when hungry is a reflex that may persist beyond the readiness for solids. Awakening for nighttime feedings is a normal behavior for a 4-month-old, and transitioning from a bottle to a cup is a later developmental milestone.

2. The parents of a 2-year-old child with a history of febrile seizures are being taught by the healthcare provider. Which statement by the parents indicates a need for further teaching?

• A. We should give our child acetaminophen when they have a fever.
• B. We should not place our child in a cool bath during a seizure.
• C. We should call 911 if the seizure lasts longer than 5 minutes.
• D. We should try to keep our child’s fever under control.

Correct answer: B

Rationale: Placing a child in a cool bath during a seizure is not recommended as it can be dangerous and may lead to accidental drowning or injuries. The priority during a febrile seizure is to ensure the safety of the child by placing them on a soft surface, removing any nearby objects that may cause harm, and gently turning their head to the side to prevent aspiration. Cooling measures like removing excess clothing can be employed, but immersing the child in a cool bath is not advised. Calling 911 if the seizure lasts longer than 5 minutes is important to seek immediate medical assistance. Administering acetaminophen to reduce fever and trying to keep the child's fever under control are appropriate interventions which should be continued.

3. The parents of a 3-month-old infant are being educated by the healthcare provider about safe sleep practices. Which statement by the parents indicates a need for further teaching?

• A. We will place our baby on their back to sleep
• B. We will use a firm mattress and avoid soft bedding
• C. We will keep our baby in our bed so we can monitor them closely
• D. We will avoid putting toys or pillows in the crib

Correct answer: C

Rationale: The correct answer is C. Co-sleeping, or keeping the baby in the parents' bed, increases the risk of sudden infant death syndrome (SIDS). It is crucial for parents to place the baby in a separate crib or bassinet to ensure a safe sleep environment and reduce the risk of SIDS. Choices A, B, and D demonstrate understanding of safe sleep practices by mentioning placing the baby on their back, using a firm mattress and avoiding soft bedding, and not putting toys or pillows in the crib, which are all measures to promote safe sleep and reduce the risk of SIDS.

4. The healthcare provider is providing postoperative care to a 4-year-old child who underwent tonsillectomy. The provider notices that the child is frequently swallowing. What should the provider do first?

• A. Check the child’s throat for signs of bleeding
• B. Offer the child ice chips to soothe the throat
• C. Elevate the head of the child’s bed
• D. Administer prescribed pain medication

Correct answer: A

Rationale: Frequent swallowing after tonsillectomy may indicate bleeding, which requires immediate assessment and intervention. Checking the child’s throat for signs of bleeding is the priority to ensure timely identification and management of any potential bleeding complications.

5. A 9-week-old infant is scheduled for cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?

• A. Red blood cell count of 2.3 million/mm³
• B. White blood cell count of 10,000/mm³
• C. Weight gain of 2 pounds since birth
• D. Urine specific gravity is 1.011

Correct answer: A

Rationale: The correct answer is A because a low red blood cell count may indicate anemia, which could pose risks during surgery. Anemia can affect oxygen delivery to tissues, impacting wound healing and overall surgical outcomes. The other options, such as white blood cell count, weight gain, and urine specific gravity, are less critical for immediate surgical considerations. White blood cell count is more related to infection risk postoperatively rather than immediate surgical risk. Weight gain reflects good overall growth but does not impact the immediate surgical situation. Urine specific gravity is more indicative of hydration status rather than immediate surgical risk.

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