Nursing Elites

1. A newborn's parents are being taught about ways to prevent sudden infant death syndrome (SIDS). Which of the following instructions should be included?

• A. Place the infant in a prone position to sleep.
• B. Allow the infant to sleep on a large pillow.
• C. Use a soft mattress in the infant's crib.
• D. Give the infant a pacifier at bedtime.

Correct answer: D

Rationale: The correct instruction to prevent SIDS is to give the infant a pacifier at bedtime. The use of a pacifier while the infant is sleeping is associated with a decreased risk of SIDS. Placing the infant on their back to sleep is recommended to prevent SIDS, not in a prone position (Choice A). Allowing the infant to sleep on a large pillow (Choice B) is dangerous and increases the risk of SIDS. Using a soft mattress in the infant's crib (Choice C) is also a risk factor for SIDS, so it should be avoided. Additionally, soft bedding or pillows should be avoided to reduce the risk of SIDS.

2. Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?

• A. An undescended testicle can reduce fertility.
• B. The testicle usually descends spontaneously during the first month of life.
• C. Surgical correction reduces the risk for testicular tumors.
• D. The optimal time to surgically correct the condition is at diagnosis.

Correct answer: A

Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.

3. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

4. A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as?

• A. Cystometrogram
• B. Cystoscopy
• C. Voiding cystourethrogram
• D. Intravenous pyelogram

Correct answer: C

Rationale: The correct test for an x-ray examination of the bladder and urethra before and during micturition is a voiding cystourethrogram. This procedure allows visualization of the bladder and urethra while the patient is urinating to assess for any abnormalities in the anatomy or function of these structures.

5. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

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