A nurse teaches a young couple to put their newborn on his back to sleep. What is the rationale for this information?

Correct Answer: A

Rationale: Teaching parents to place a newborn supine (on the back) aims to reduce sudden infant death syndrome (SIDS), a leading cause of infant mortality. 'Prone position increases the risk for sudden infant death syndrome' is correct; studies (e.g., AAP guidelines since 1992's 'Back to Sleep' campaign) show prone sleeping raises SIDS risk 2-13 times, possibly via airway obstruction or rebreathing CO2-rich air. Choice B, 'prone position decreases the risk,' is false, contradicting evidence. Choice C, 'supine position may alter the size and shape of the infant's head,' notes positional plagiocephaly (flat head), but this cosmetic issue is manageable (e.g., tummy time) and less critical than SIDS. Choice D, 'supine position makes changing diapers and feeding difficult,' is impractical and unfounded; supine is standard for sleep, not care tasks. For example, SIDS rates dropped 50% post-campaign, prioritizing safety over minor concerns. Choice A reflects this life-saving rationale, making it correct.

Correct Answer: D

Rationale: Independent nursing actions don't require orders, aiding sleep autonomously. 'Giving a back massage' is correct; it relaxes muscles and boosts parasympathetic tonee.g., 10 minutes reduces cortisol, cutting sleep latency by 15 minutesper nursing scope in Taylor. 'Administering prescribed sleep medications' is dependent, needing a physician's ordere.g., zolpidem isn't nurse-initiated. 'Changing the bed with fresh linens' comforts but doesn't directly induce sleepe.g., no physiological trigger. 'Encouraging naps during the daytime' disrupts night sleepe.g., a 2 p.m. nap delays 11 p.m. onset. Massage, a hands-on skill, promotes rest without drugs, making Choice D the correct independent action.

Correct Answer: A

Rationale: Chronic pain persists beyond healing, typically >3-6 months. 'A patient with rheumatoid arthritis' fitse.g., joint pain for years, per Taylor's pain typology, from ongoing inflammation. 'A patient with pneumonia' has acute paine.g., pleuritic pain resolves with antibiotics in weeks. 'A patient with controlled hypertension' rarely has paine.g., asymptomatic unless crisis. 'A patient with the flu' has acute myalgiae.g., 5-7 days, not chronic. RA's unremitting naturee.g., daily stiffnesscontrasts with temporary illnesses, making Choice A correct.

Correct Answer: A

Rationale: Back massage for pain relief leverages neuroscience. 'Gate control theory' motivates it; non-painful touch (e.g., massage) activates large A-beta fibers, closing spinal 'gates' to pain signals from smaller A-delta/C fibers, per Melzack and Wall, cited in Taylor. 'Neuromodulation' involves devices (e.g., TENS), not handse.g., electrical, not manual. 'Large/small fiber theory' is a misnomer; it's part of gate control, not distinct. 'Prostaglandin stimulation' worsens paine.g., inflammation, not relief. Massagee.g., 10 minutes on the backreduces perceived intensity (e.g., 6/10 to 3/10) by competing stimuli, a nursing staple. Choice A is the correct theoretical basis.

Correct Answer: D

Rationale: Post-op urinary retention mimics pain. 'Palpate abdomen for distended bladder' is correcte.g., a firm, tender suprapubic mass suggests 400 mL retention, per Taylor's assessment, causing pain and restlessness. Choice A, 'last bowel movement,' tracks constipatione.g., unrelated to 8-hour void gap. Choice B, 'auscultate bowel sounds,' checks GIe.g., hypoactive post-op, not urinary. Choice C, 'percuss for tympany,' assesses aire.g., bowel, not bladder fullness. Palpatione.g., dullness over bladderconfirms retention (common post-anesthesia) before opioids, which worsen it. Nurses prioritize causee.g., catheterize, not mask with medsmaking Choice D the right step.