Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is providing teaching about infant nutrition to a group of parents and guardians. Which of the following statements should the nurse include?
A. "Introduce solid foods when the infant reaches 3 months of age."
"Introduce solid foods when the infant reaches 3 months of age." Solid foods should be introduced around 4 to 6 months of age, when the infant shows signs of readiness (e.g., sitting with support, loss of tongue-thrust reflex).
B. "Offer 1 tablespoon as a serving size for the infant's solid food."
"Offer 1 tablespoon as a serving size for the infant's solid food." A general guideline is 1 tablespoon of food per year of age per serving, so for an infant just starting solids, 1 tablespoon is appropriate per meal.
C. "Add 1 teaspoon of honey to the infant's bottle of formula if constipation occurs."
"Add 1 teaspoon of honey to the infant's bottle of formula if constipation occurs." Honey should not be given to infants under 1 year old due to the risk of botulism.
D. "Introduce the infant to a new solid food every other day."
"Introduce the infant to a new solid food every other day." New foods should be introduced one at a time, every 3 to 5 days, to monitor for potential allergic reactions.
This question is an excerpt from Nurse Dive's nursing test bank - Ati rn paediatrics nursing proctored exam 2023. Take the full exam now
Full Explanation
A. "Introduce solid foods when the infant reaches 3 months of age." Solid foods should be introduced around 4 to 6 months of age, when the infant shows signs of readiness (e.g., sitting with support, loss of tongue-thrust reflex).
B. "Offer 1 tablespoon as a serving size for the infant's solid food." A general guideline is 1 tablespoon of food per year of age per serving, so for an infant just starting solids, 1 tablespoon is appropriate per meal.
C. "Add 1 teaspoon of honey to the infant's bottle of formula if constipation occurs." Honey should not be given to infants under 1 year old due to the risk of botulism.
D. "Introduce the infant to a new solid food every other day." New foods should be introduced one at a time, every 3 to 5 days, to monitor for potential allergic reactions.
Similar Questions
A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and ingested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should the nurse take?
A. Perform gastric lavage with activated charcoal.
Perform gastric lavage with activated charcoal. Activated charcoal is most effective if given within 1 hour of ingestion. Since the ingestion occurred 4 hours ago, activated charcoal would not be beneficial.
B. Begin hemodialysis within the next 24 hr.
Begin hemodialysis within the next 24 hr. Hemodialysis is only used in severe cases of acetaminophen toxicity with liver failure, which is not indicated at this stage.
C. Prepare to give oral N-acetylcysteine.
Prepare to give oral N-acetylcysteine. N-acetylcysteine (NAC) is the antidote for acetaminophen overdose and should be administered as soon as possible within 8 to 10 hours after ingestion to prevent liver damage.
D. Send the child home on increased fluid intake.
Send the child home on increased fluid intake. Acetaminophen overdose can cause severe liver toxicity, so treatment in a medical setting is required, not just increased fluids at home.
Full Explanation
A. Perform gastric lavage with activated charcoal. Activated charcoal is most effective if given within 1 hour of ingestion. Since the ingestion occurred 4 hours ago, activated charcoal would not be beneficial.
B. Begin hemodialysis within the next 24 hr. Hemodialysis is only used in severe cases of acetaminophen toxicity with liver failure, which is not indicated at this stage.
C. Prepare to give oral N-acetylcysteine. N-acetylcysteine (NAC) is the antidote for acetaminophen overdose and should be administered as soon as possible within 8 to 10 hours after ingestion to prevent liver damage.
D. Send the child home on increased fluid intake. Acetaminophen overdose can cause severe liver toxicity, so treatment in a medical setting is required, not just increased fluids at home.
A nurse is teaching an 11-year-old child about ways to cope with stress. Which of the following statements should the nurse make?
A. "It is okay to blame others for your feelings."
"It is okay to blame others for your feelings." Blaming others is a negative coping mechanism that does not help the child manage emotions in a healthy way.
B. "When you feel angry and overwhelmed, take some deep breaths."
"When you feel angry and overwhelmed, take some deep breaths." Deep breathing is a positive coping strategy that helps reduce stress and manage emotions effectively.
C. "Take a break from group activities when you are stressed."
"Take a break from group activities when you are stressed." Social support is an important stress reliever, and withdrawing from activities may lead to isolation and worsen stress.
D. "Keep your strong feelings to yourself."
"Keep your strong feelings to yourself." Bottling up emotions can lead to increased stress and anxiety. Children should be encouraged to express their feelings in a healthy way.
Full Explanation
A. "It is okay to blame others for your feelings." Blaming others is a negative coping mechanism that does not help the child manage emotions in a healthy way.
B. "When you feel angry and overwhelmed, take some deep breaths." Deep breathing is a positive coping strategy that helps reduce stress and manage emotions effectively.
C. "Take a break from group activities when you are stressed." Social support is an important stress reliever, and withdrawing from activities may lead to isolation and worsen stress.
D. "Keep your strong feelings to yourself." Bottling up emotions can lead to increased stress and anxiety. Children should be encouraged to express their feelings in a healthy way.
A nurse is preparing to insert a peripheral intravenous (IV) catheter for a preschooler. Which of the following actions should the nurse take?
A. Ask the child to hold their breath while the IV catheter is placed.
"Ask the child to hold their breath while the IV catheter is placed." Holding breath can increase anxiety and is not necessary for IV insertion. Instead, distraction techniques (e.g., deep breathing, counting) are more effective.
B. Explain the procedure to the child in detail.
"Explain the procedure to the child in detail." Preschoolers have limited understanding of medical procedures. Instead, use simple, age-appropriate language and possibly a demonstration with a toy.
C. Apply vapocoolant spray before the IV insertion.
"Apply vapocoolant spray before the IV insertion." Vapocoolant spray or topical anesthetics (e.g., EMLA cream) help reduce pain and anxiety associated with IV insertion.
D. Place the IV catheter on the dominant arm.
"Place the IV catheter on the dominant arm." IV placement is typically based on vein accessibility, not dominance. However, placing it on the non-dominant arm may be preferable to avoid interference with activities.
Full Explanation
A. "Ask the child to hold their breath while the IV catheter is placed." Holding breath can increase anxiety and is not necessary for IV insertion. Instead, distraction techniques (e.g., deep breathing, counting) are more effective.
B. "Explain the procedure to the child in detail." Preschoolers have limited understanding of medical procedures. Instead, use simple, age-appropriate language and possibly a demonstration with a toy.
C. "Apply vapocoolant spray before the IV insertion." Vapocoolant spray or topical anesthetics (e.g., EMLA cream) help reduce pain and anxiety associated with IV insertion.
D. "Place the IV catheter on the dominant arm." IV placement is typically based on vein accessibility, not dominance. However, placing it on the non-dominant arm may be preferable to avoid interference with activities.