Nursing Elites

1. At what age range is it important to feed a baby in a more upright position and no longer in sidelying?

• A. 6-12 months
• B. 4-6 months
• C. 12-18 months
• D. Birth to 3 months

Correct answer: B

Rationale: Feeding a baby in a more upright position and no longer in sidelying is important around 4-6 months of age. At this stage, babies start developing better head and trunk control, which allows them to sit in a more upright position for feeding, promoting safer and more efficient swallowing and digestion. Choices A, C, and D are incorrect as feeding a baby in a more upright position typically starts around 4-6 months when the baby has gained more control over their head and trunk movements, making it safer and more effective for feeding.

2. A patient with Parkinson’s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?

• A. Have you noticed any swelling in your feet?
• B. Are you having vivid dreams or hallucination?
• C. Have you noticed any changes in your stool?
• D. Have you had your flu vaccine?

Correct answer: B

Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.

3. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

4. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?

• A. Vital signs and neurologic checks hourly
• B. Small, frequent formula feedings
• C. Elevate the head of the bed
• D. Daily head circumference measurements

Correct answer: C

Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.

5. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?

• A. Bag-valve-mask system
• B. Sterile gauze and saline
• C. Soft arm restraints
• D. Endotracheal tube

Correct answer: D

Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.

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