Nursing Elites

1. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.

2. The parents of a 1-month-old girl with Down syndrome are being taught by the nurse on how to maintain the child's good health. Which instruction would the nurse be least likely to include?

• A. Getting cervical radiographs between 3 and 5 years of age
• B. Adhering to the special dietary needs of the child
• C. Getting an echocardiogram before 3 months of age
• D. Monitoring for symptoms of respiratory infection

Correct answer: B

Rationale: The correct answer is B. While special dietary needs may be important, they are not typically a primary concern for a 1-month-old with Down syndrome compared to monitoring for congenital issues. Getting cervical radiographs, an echocardiogram, and monitoring for respiratory infections are more crucial in the early care of a child with Down syndrome. Cervical radiographs help in assessing for atlantoaxial instability, an echocardiogram is important for detecting congenital heart defects common in Down syndrome, and monitoring for respiratory infections is vital due to the increased risk in these children.

3. A nurse is teaching a parent how to prevent accidents while caring for a 6-month-old infant. What ability should be emphasized regarding the infant’s motor development?

• A. Sits up
• B. Rolls over
• C. Crawls short distances
• D. Stands while holding on to furniture

Correct answer: B

Rationale: The correct answer is "B: Rolls over." At 6 months, most infants can roll over, which increases the risk of falls. Emphasizing the infant's ability to roll over is crucial to highlight the need for careful supervision and accident prevention. Choices A, C, and D are incorrect because sitting up, crawling short distances, and standing while holding on to furniture typically develop later in an infant's motor skills progression and are not as directly associated with an increased risk of accidents at this stage.

4. A parent tells a nurse at the clinic, 'Each morning I offer my 24-month-old child juice, and all I hear is ‘No.’ What should I do because I know my child needs fluid?' What strategy should the nurse suggest?

• A. Offer the child a choice of two juices.
• B. Distract the child with a favorite food.
• C. Offer the child the glass in a firm manner.
• D. Allow the child to see the parent getting angry.

Correct answer: A

Rationale: Offering a choice between two options allows the child to feel a sense of control while ensuring they get the necessary fluids. Providing a choice empowers the child and increases the likelihood of cooperation. Distracting the child with food or offering the glass in a firm manner may not address the underlying issue of refusal. Allowing the child to witness the parent's anger can create a negative environment and may not help in resolving the situation positively.

5. A health care provider orders a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question the order?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas do not directly lead to loss of necessary nutrients. Choice C is incorrect as it focuses on emotional impact rather than physiological risks. Choice D is incorrect as shock from a sudden drop in temperature is not a common consequence of a tap water enema in this scenario.

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