Nursing Elites

1. Where is the most appropriate location to perform a procedure on a preschooler?

• A. Perform the procedure in the child's hospital bed.
• B. Perform the procedure in the treatment room.
• C. Allow the child to decide when the procedure will be performed.
• D. Ask the parents to help restrain the child so the procedure can be performed.

Correct answer: B

Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.

2. What is the most important intervention to decrease the stressors of hospitalization for a 9-month-old infant being treated for a bacterial infection?

• A. Encourage the infant's parents to remain at the bedside and actively participate in the infant's care.
• B. Provide a brightly lit environment for the infant.
• C. Play tapes of the mother's voice.
• D. Assign the same nurse to the infant as much as possible.

Correct answer: A

Rationale: Encouraging the infant's parents to remain at the bedside and actively participate in the infant's care is crucial in decreasing the stressors of hospitalization for the infant. Parental presence provides comfort and security, promotes bonding, and maintains a sense of familiarity for the infant during a potentially stressful situation. This involvement can help reduce anxiety and promote better outcomes for the infant's emotional well-being and overall hospital experience. Providing a brightly lit environment (choice B) can actually increase stress for the infant, as infants generally prefer dimly lit environments for better sleep. Playing tapes of the mother's voice (choice C) may offer some comfort but does not substitute for parental presence. While assigning the same nurse to the infant (choice D) can provide continuity of care, it is not as effective as having the parents present for emotional support and bonding.

3. The caregiver is teaching a new mother about infant safety. Which statement indicates that further teaching is needed?

• A. I will place my baby on their back to sleep.
• B. I will keep soft toys and pillows out of the crib.
• C. I will use a car seat for every car ride.
• D. I will allow my baby to sleep in my bed.

Correct answer: D

Rationale: Allowing a baby to sleep in an adult bed increases the risk of suffocation and Sudden Infant Death Syndrome (SIDS). It is safer for infants to sleep on a firm, flat surface in their own crib or bassinet to reduce the risk of accidental suffocation or strangulation. Therefore, the caregiver should be advised against co-sleeping with the infant to ensure the baby's safety.

4. What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?

• A. Insert the needle and aspirate before injecting
• B. Inject insulin into the extremity to be exercised to improve absorption
• C. The muscles in the abdomen and thigh are the easiest for self-administration
• D. Clean the injection site with soap and water and avoid alcohol

Correct answer: C

Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.

5. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

• A. begin ventilations with a bag-mask device.
• B. gently flick the soles of their feet for up to 60 seconds.
• C. immediately suction their mouth and nose.
• D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

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