Nursing Elites

1. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?

• A. Respond to name
• B. React to loud noise with Moro reflex
• C. Turn his or her head to side when sound is at ear level
• D. Locate sound by turning his or her head in a curving arc

Correct answer: B

Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.

2. At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?

• A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
• B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
• C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
• D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.

Correct answer: D

Rationale: Encouraging the baby to fall asleep in the crib while still awake can help establish healthy sleep habits and reduce night waking.

3. What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?

• A. Playing peek-a-boo
• B. Playing pat-a-cake
• C. Imitating animal sounds
• D. Showing how to clap hands

Correct answer: A

Rationale: Playing peek-a-boo is an ideal play activity for a 7-month-old as it encourages visual tracking and social interaction, which are key developmental milestones at this age.

4. What is the most appropriate action for a healthcare provider if a child presents with suspected meningitis?

• A. Administer antibiotics immediately
• B. Perform a lumbar puncture
• C. Isolate the child
• D. Obtain a complete blood count

Correct answer: C

Rationale: Isolating the child is a priority to prevent the spread of infection until meningitis is confirmed or ruled out. Meningitis, particularly bacterial, is highly contagious and can lead to outbreaks if not properly managed. Isolation and prompt treatment are critical in preventing serious complications. Administering antibiotics immediately without confirmation of the diagnosis can be harmful if the cause is viral or non-infectious. Performing a lumbar puncture is a diagnostic procedure that should be done by a healthcare provider but is not the initial action when suspecting meningitis. Obtaining a complete blood count may be part of the diagnostic workup but is not the most appropriate initial action in suspected meningitis.

5. Which condition is most commonly associated with a 'sunset sign' in infants?

• A. Hydrocephalus
• B. Meningitis
• C. Cerebral palsy
• D. Encephalitis

Correct answer: A

Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'

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