Nursing Elites

1. 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.

2. When a mother of a 3-year-old boy gives birth to a baby girl and the boy asks why his baby sister is breastfeeding from their mother, how should the nurse respond? Select the option that is not appropriate.

• A. Remind him that his mother breastfed him too
• B. Clarify that breastfeeding is the mother's choice
• C. Reassure the older brother that it does not hurt his mother
• D. Explain that newborns get milk from their mothers in this way

Correct answer: B

Rationale: Choice B is not the appropriate response in this scenario. The correct answer is choice A, which normalizes the situation for the child by reminding him that his mother breastfed him too. This response helps the older brother understand that breastfeeding is a natural and common practice for newborns, including his baby sister, just as it was for him when he was a baby. Choice B, while true, does not directly address the child's question and may not provide the same level of reassurance and normalization as choice A. Choices C and D also do not directly answer the child's question and do not provide the same level of connection and understanding as choice A.

3. A 2-year-old child with respiratory syncytial virus (RSV) is being treated in the hospital. What should the healthcare provider monitor for in this child?

• A. Increased urine output.
• B. Decreased respiratory rate.
• C. Labored breathing.
• D. Improved appetite.

Correct answer: C

Rationale: Labored breathing is a critical sign of worsening respiratory distress in children with RSV. It indicates that the child's condition may be deteriorating, requiring prompt intervention to ensure adequate oxygenation and prevent respiratory failure. Monitoring for labored breathing allows healthcare providers to promptly assess and manage the child's respiratory status, potentially preventing further complications associated with RSV infection.

4. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist albuterol (Proventil). The child’s mother tells the nurse that she uses this medication to open her son’s airway when he is having trouble breathing. What is the nurse’s best response?

• A. Recommend that the mother bring the child in for immediate evaluation
• B. Advise the mother that overuse of the drug may cause chronic bronchitis
• C. Assure the mother that she is using the medication correctly
• D. Confirm that the medication helps to reduce airway inflammation

Correct answer: C

Rationale: The correct response is to assure the mother that she is using the medication correctly. Albuterol is a beta-adrenergic agonist that helps open the airways during an asthma attack. By reassuring the mother, the nurse reinforces the correct usage of the medication, which is crucial in managing the child's asthma symptoms effectively. Option A is incorrect because immediate evaluation may not be necessary if the child's symptoms are being managed effectively with albuterol. Option B is incorrect as chronic bronchitis is not typically associated with the overuse of albuterol. Option D is incorrect as albuterol primarily acts as a bronchodilator and does not directly reduce airway inflammation.

5. A 5-year-old child is brought to the emergency department with severe abdominal pain and vomiting. The child’s parent reports that the pain started suddenly and is located in the lower right abdomen. What should the nurse do first?

• A. Administer pain medication
• B. Notify the healthcare provider immediately
• C. Start an IV line for fluid administration
• D. Obtain a complete blood count

Correct answer: B

Rationale: The correct answer is to notify the healthcare provider immediately. The child's presentation of sudden, severe abdominal pain in the lower right abdomen is highly concerning for appendicitis, a medical emergency. Promptly notifying the healthcare provider is crucial for further evaluation and management. Administering pain medication as the first action might mask symptoms and delay diagnosis. Starting an IV line for fluid administration and obtaining a complete blood count are important interventions but should come after healthcare provider notification.

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