Nursing Elites

1. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

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. The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?

• A. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel
• B. I can use a music box and soft mobiles as appropriate play activities for my baby
• C. I should introduce a cup and spoon or push-pull toys for my baby at this age
• D. I do not have to worry about appropriate play activities at this age

Correct answer: B

Rationale: At 2 months, infants are most stimulated by visual and auditory activities, such as a music box or soft mobiles. These activities help in sensory development and are appropriate for this age.

4. Which immunization is recommended for all newborns?

• A. Hepatitis A vaccine
• B. Hepatitis B vaccine
• C. Hepatitis C vaccine
• D. Hepatitis A, B, and C vaccines

Correct answer: B

Rationale: The correct answer is B, the Hepatitis B vaccine. This vaccine is recommended for all newborns to prevent Hepatitis B infection, which can lead to chronic liver disease and liver cancer. The Hepatitis B vaccine is a crucial part of the routine immunization schedule for infants. Choices A, C, and D are incorrect because the recommended vaccine for newborns is specifically Hepatitis B, not Hepatitis A, Hepatitis C, or a combination of Hepatitis A, B, and C vaccines.

5. At what age is the first dose of the hepatitis A vaccine recommended to be started?

• A. 1 year
• B. 1 month
• C. 12 years
• D. It is not recommended at any age

Correct answer: A

Rationale: The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.

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