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. During a home care visit for an infant diagnosed with gastroesophageal reflux, which parental action observed requires intervention by the nurse?

• A. The infant's formula is mixed with rice cereal.
• B. The mother positions the infant in a high Fowler position while feeding.
• C. After feeding, the infant is placed in a car seat.
• D. The mother administers ranitidine (Zantac) to the infant using a syringe.

Correct answer: C

Rationale: Placing an infant diagnosed with gastroesophageal reflux in a car seat after feeding can increase the risk of reflux and aspiration. The semi-upright or high Fowler position is recommended to help reduce reflux symptoms during feeding. Adding rice cereal to formula can help thicken it and reduce reflux episodes. Administering ranitidine using a syringe is a common method of oral medication administration. Therefore, the action of placing the infant in a car seat after feeding is the one that requires intervention due to the increased risk it poses.

3. Which strategy is most effective in preventing existing challenging behaviors?

• A. Ignoring the behaviors
• B. Individualized interventions
• C. Providing flexible rules
• D. Punishment

Correct answer: B

Rationale: Individualized interventions are tailored to address the specific needs and triggers of the individual's challenging behaviors. By customizing the approach to each person, it increases the likelihood of effectively preventing and managing the existing challenging behaviors.

4. When developing a home program for self-care, which approach is the most effective?

• A. Require the parent to practice the steps regularly and track progress.
• B. Introduce new home programs weekly with clear instructions for the parent to follow.
• C. List all the steps and have the parent teach them to the child without practicing.
• D. Practice the new steps until the child is ready to independently perform them at home.

Correct answer: D

Rationale: The most effective approach when developing a home program for self-care is to practice the new steps with the child until they are capable of independently carrying them out at home. This method ensures that the child has mastered the skills before transitioning to independent implementation. It is essential for the child's success in self-care activities and promotes their autonomy and confidence. Requiring the parent to practice the steps regularly and track progress, introducing new programs weekly, or having the parent teach the steps without practice may not be as beneficial in fostering the child's independence and skill acquisition.

5. In which frame of reference do activities involve responses to movement, balance, weight bearing, and tactile activities?

• A. Motor control/motor learning
• B. Ayres' sensory integration
• C. Neurodevelopmental treatment
• D. Developmental

Correct answer: B

Rationale: Ayres' sensory integration focuses on activities that target responses to movement, balance, weight bearing, and tactile stimuli to improve sensory processing and integration. This approach aims to address sensory challenges through structured activities to enhance overall function and participation. Motor control/motor learning (Choice A) deals with the control and coordination of voluntary movements. Neurodevelopmental treatment (Choice C) focuses on facilitating normal movement patterns and postural control. Developmental (Choice D) refers to the natural sequence of growth and development in children.

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