Nursing Elites

1. Which of the following statements regarding SIDS is correct?

• A. SIDS can occur in premature infants.
• B. It is most commonly a result of child abuse.
• C. Death usually occurs during sleep.
• D. SIDS can be prevented by placing the baby on its back to sleep.

Correct answer: C

Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.

2. A breastfeeding mother reports to the nurse that her newborn nurses every hour and never seems satisfied. Which advice should the nurse provide?

• A. Supplement breastfeeding with formula after each nursing session.
• B. Allow the newborn to nurse on each breast for at least 20 minutes.
• C. Reduce the number of nursing sessions to every 2-3 hours.
• D. Ensure the newborn has a proper latch and is effectively nursing.

Correct answer: D

Rationale: The nurse should ensure that the newborn has a proper latch and is effectively nursing. Sometimes, newborns nurse frequently for comfort even when they are effectively latched. It is essential to address the latch first before considering other interventions. Supplementing with formula (Choice A) may decrease the mother's milk supply. Allowing the newborn to nurse for a set time (Choice B) may not address the underlying latch issue. Reducing nursing sessions (Choice C) may lead to decreased milk production and does not address the latch problem.

3. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:

• A. placing the child supine and palpating the abdomen.
• B. separating the child from the parent to ensure a reliable examination.
• C. examining the child in the parent's arms.
• D. palpating the painful area of the abdomen first.

Correct answer: C

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.

4. How should you assist with the delivery of the baby's head?

• A. Grasping each side of the baby's head and gently pulling to facilitate delivery.
• B. Placing your fingers on the bony part of the skull and applying gentle pressure.
• C. Carefully rotating the baby's head to face up during delivery.
• D. Placing the palm of your hand firmly against the back of the baby's skull.

Correct answer: B

Rationale: To assist with the delivery of the baby's head, the correct technique involves placing your fingers on the bony part of the skull and applying gentle pressure. This method helps guide the baby's head through the birth canal safely and effectively. Choices A, C, and D are incorrect. Grasping and pulling the baby's head, rotating the head, or placing the palm of your hand against the back of the baby's skull can potentially cause harm or complications during delivery.

5. A toddler is admitted to the hospital because of sudden hoarseness, holding or pointing to their neck, and continuous cough. The nurse will be particularly concerned about:

• A. Acute respiratory tract infection
• B. Respiratory tract obstruction caused by a foreign body
• C. Retropharyngeal abscess
• D. Undetected laryngeal abnormality

Correct answer: B

Rationale: In a toddler presenting with sudden hoarseness, holding or pointing to their neck, and continuous cough, the nurse should be particularly concerned about respiratory tract obstruction caused by a foreign body. These symptoms are indicative of a possible foreign body in the airway, which can lead to serious complications and requires immediate attention to ensure the toddler's airway remains patent and unobstructed.

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