Nursing Elites

1. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

• A. Keep buttons, beads, and other small objects out of his reach.
• B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
• C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
• D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.

Correct answer: A

Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.

2. The caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse?

• A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately.
• B. The extrusion reflex must be developed and feeding solid foods will help the infant to develop this reflex.
• C. Breastfeeding will become painful when the infant gets more teeth, so the infant needs to eat solid foods.
• D. By this age the infant becomes interested in trying new skills.

Correct answer: A

Rationale: The correct response is A. Solid foods, especially iron-fortified cereals, are introduced to meet the infant's increased nutritional needs, including iron, which breast milk alone may not provide adequately. Choice B is incorrect because the extrusion reflex is related to the tongue-thrust reflex, not the nutritional needs of the infant. Choice C is incorrect as breastfeeding does not become painful when the infant gets more teeth, and it is not a reason for introducing solid foods. Choice D is incorrect as the infant's interest in trying new skills is not a primary reason for introducing solid foods at this age.

3. What is the number one leading cause of death in children over 1 year of age?

• A. Congenital anomalies
• B. Homicide
• C. Suicide
• D. Accidents

Correct answer: D

Rationale: Accidents, such as motor vehicle accidents, drowning, and falls, are the primary cause of death in children over 1 year of age. While congenital anomalies can be a significant cause of mortality in infants, they are less common in older children. Homicide and suicide are serious issues but are not as prevalent as accidents in causing death among children over 1 year of age.

4. The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?

• A. Childhood obesity is the most common nutritional problem among children
• B. Immunization rates are the same among children of different races and ethnicity
• C. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water
• D. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents

Correct answer: A

Rationale: Childhood obesity is the most common nutritional problem in children, with significant implications for long-term health, including the risk of developing chronic diseases.

5. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

• A. Advise bed rest until 1 week after the icteric phase.
• B. Teach infection control measures to family members.
• C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
• D. Reassure the mother that hepatitis A cannot be transmitted to other family members.

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

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