Nursing Elites

1. When conducting a class for parents about sudden infant death syndrome (SIDS), the nurse instructs the class that the infant should be placed in which position to sleep?

• A. Right side-lying
• B. Left side-lying
• C. Prone
• D. Supine

Correct answer: D

Rationale: The correct answer is D, supine. The American Academy of Pediatrics recommends placing infants on their back, or supine, to sleep as it has been shown to reduce the risk of SIDS. Choices A, B, and C are incorrect because placing infants on their right side, left side, or prone (on their stomach) respectively are not recommended sleeping positions due to the increased risk of SIDS associated with those positions.

2. What are early signs of varicella disease?

• A. High fever over 101°F (38.3°C)
• B. General malaise
• C. Increased appetite
• D. Crusty sores

Correct answer: B

Rationale: The correct early sign of varicella disease is general malaise. During the prodromal period, patients may experience low-grade fever, malaise, and anorexia. Increased appetite and crusty sores are not typically early signs of varicella. The appearance of lesions occurs later in the course of the disease.

3. Which laboratory results should the nurse anticipate to be abnormal in a child with hemophilia?

• A. Prothrombin time
• B. Bleeding time
• C. Platelet count
• D. Partial thromboplastin time

Correct answer: D

Rationale: In a child with hemophilia, the nurse should anticipate an abnormality in the partial thromboplastin time (PTT) due to the deficiency in clotting factors. Prothrombin time, bleeding time, and platelet count are typically normal in hemophilia. Prothrombin time measures the extrinsic pathway of coagulation and is not affected in hemophilia. Bleeding time assesses platelet function, which is normal in hemophilia as the issue lies with clotting proteins, not platelets. Platelet count is also expected to be normal unless there is another underlying condition affecting platelet production or function.

4. A client with chronic kidney disease is receiving epoetin alfa. Which laboratory value should the nurse monitor to determine the effectiveness of the treatment?

• A. Blood urea nitrogen (BUN)
• B. Serum creatinine
• C. Hemoglobin and hematocrit
• D. Serum potassium

Correct answer: C

Rationale: The correct answer is C: Hemoglobin and hematocrit. Epoetin alfa is a medication that stimulates red blood cell production, so monitoring hemoglobin and hematocrit levels is essential to assess its effectiveness. These values reflect the oxygen-carrying capacity of the blood and can indicate if the treatment is improving anemia related to chronic kidney disease. Choices A, B, and D are incorrect. Blood urea nitrogen (BUN) and serum creatinine are indicators of kidney function, while serum potassium levels are monitored due to electrolyte imbalances commonly seen in kidney disease, but they do not directly reflect the effectiveness of epoetin alfa.

5. When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

• A. Obtain arterial blood gases (ABGs) before the procedure.
• B. Explain that the client may be positioned in five different ways.
• C. Assist the patient into a position that will allow gravity to move secretions.
• D. Encourage the client to practice deep breathing throughout the procedure.

Correct answer: C

Rationale: The correct approach when performing postural drainage on a client with COPD is to assist the patient into a position that allows gravity to help move secretions. This position helps drain secretions from specific segments of the lungs. Obtaining arterial blood gases (Choice A) is not directly related to postural drainage. While the client may be placed in multiple positions during postural drainage, the key is to position them to facilitate the movement of secretions, not just any five positions as mentioned in Choice B. Encouraging deep breathing (Choice D) is a good nursing intervention for overall respiratory health but is not specifically related to the technique of postural drainage.

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