Nursing Elites

1. When teaching a class of new parents about positioning their infants during the first few weeks of life, which position is safest?

• A. On the back, lying flat
• B. On either side, lying flat
• C. Head slightly elevated on the left side
• D. Head slightly elevated on the right side

Correct answer: A

Rationale: The correct answer is A: 'On the back, lying flat'. Placing infants on their back to sleep is recommended to reduce the risk of sudden infant death syndrome (SIDS). This position helps ensure the baby's airway remains clear and reduces the likelihood of suffocation. Choices B, C, and D are not as safe as placing the infant on their back, as they may increase the risk of accidental suffocation or SIDS.

2. How should you care for an alert 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color?

• A. Back blows, abdominal thrusts, transport
• B. Oxygen, avoiding agitation, transport
• C. Assisting ventilations, back blows, transport
• D. Chest thrusts, finger sweeps, transport

Correct answer: B

Rationale: The correct approach for an alert 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color is to provide oxygen, avoid agitation, and arrange for transport. Oxygen helps support breathing, avoiding agitation prevents worsening of the obstruction, and transport ensures the child receives further medical evaluation and treatment. Choices A, C, and D involve techniques that are not recommended for a mild airway obstruction in this scenario. Back blows, abdominal thrusts, chest thrusts, and finger sweeps are interventions used for different situations and not suitable for a child with the described symptoms.

3. The healthcare provider is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

• A. abdominal rigidity and pain on palpation
• B. rounded abdomen and hypoactive bowel sounds
• C. visible peristalsis and weight loss
• D. distention of lower abdomen and constipation

Correct answer: C

Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. Visible peristalsis refers to the wave-like movements in the abdomen caused by the stomach trying to empty into the intestines due to the obstruction at the pylorus. Weight loss is often seen due to inadequate feeding and vomiting associated with this condition. Choices A, B, and D are not typical of pyloric stenosis. Abdominal rigidity and pain on palpation are more indicative of conditions like peritonitis. A rounded abdomen and hypoactive bowel sounds are more suggestive of conditions like constipation or bowel obstruction. Distention of the lower abdomen and constipation are not specific to pyloric stenosis and may be seen in various gastrointestinal issues.

4. What behavior does a toddler subjected to prolonged hospitalization with limited parental visits typically exhibit?

• A. Cheerful interactions with staff members
• B. Indications of sadness throughout the day
• C. Excessive crying when parents are not present
• D. Limited emotional response to the environment

Correct answer: D

Rationale: Toddlers subjected to prolonged hospitalization with limited parental visits often exhibit a limited emotional response to the environment. This behavior is a common coping mechanism in young children facing such situations. While cheerful interactions with staff members (choice A) may occur occasionally, the overall response tends to be subdued. Indications of sadness throughout the day (choice B) and excessive crying when parents are not present (choice C) are less typical in this scenario, as the child may have learned to suppress emotions due to the challenging circumstances.

5. A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect

• A. croup
• B. epiglottitis
• C. lower respiratory infection
• D. foreign body airway obstruction

Correct answer: D

Rationale: In a 3-year-old child presenting with sudden respiratory distress and no history of recent illnesses or fever, foreign body airway obstruction should be suspected. Foreign body airway obstruction commonly leads to acute respiratory distress without preceding symptoms. Croup (Choice A) typically presents with a barking cough and stridor. Epiglottitis (Choice B) often presents with high fever, drooling, and a muffled voice. Lower respiratory infection (Choice C) may manifest with symptoms such as cough, fever, and respiratory distress, but the sudden onset without fever or recent illness suggests a more acute event like foreign body airway obstruction.

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