Nursing Elites

1. When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:

• A. Focusing all of your attention on the infant, with minimal parental interaction.
• B. Carefully inspecting the environment in which the infant was found.
• C. Understanding that most infants with SIDS can be successfully resuscitated.
• D. Encouraging the presence of the parents during your resuscitation attempt.

Correct answer: B

Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.

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. 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.

4. When assessing a newborn for jaundice, which area should be examined?

• A. Legs and feet
• B. Chest and abdomen
• C. Face and sclera
• D. Back and buttocks

Correct answer: C

Rationale: When assessing a newborn for jaundice, the healthcare provider should examine the face and sclera. Jaundice is often first noticeable in these areas due to the buildup of bilirubin, causing a yellowish discoloration of the skin and eyes. Examining the legs and feet (Choice A) is not the most appropriate area for identifying jaundice in newborns. Similarly, the chest and abdomen (Choice B) are not the primary areas where jaundice is usually observed. Checking the back and buttocks (Choice D) is also not as useful as examining the face and sclera when assessing for jaundice in newborns.

5. The healthcare provider assesses the newborn's ears to be parallel to the outer and inner canthus of the eye. The healthcare provider documents this finding to be which of the following?

• A. A normal position
• B. A possible chromosomal abnormality
• C. Facial paralysis
• D. Prematurity

Correct answer: A

Rationale: When the top of the ear (pinna) is parallel to the outer and inner canthus of the eye, it is considered a normal position in a newborn. This alignment is an important assessment to ensure normal development and anatomy. Choices B, C, and D are incorrect because the parallel alignment of the ears to the outer and inner canthus of the eye is not indicative of a possible chromosomal abnormality, facial paralysis, or prematurity. It is simply a normal anatomical finding in a newborn.

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