The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on knowledge that this is:

Correct Answer: D

Rationale: The correct answer is D) acceptable to encourage head control and turning over. This response is based on the developmental stage of a 3-month-old infant. At this age, infants are typically developing head control and starting to learn how to turn over. Allowing the infant to have supervised tummy time while awake helps strengthen their neck muscles, promote head control, and eventually leads to the ability to roll over. This position also helps prevent flat spots on the back of the infant's head. Option A) is incorrect because placing the infant on their tummy while awake and supervised does not increase the risk of Sudden Infant Death Syndrome (SIDS). In fact, the American Academy of Pediatrics recommends supervised tummy time to promote motor development and prevent positional plagiocephaly (flat head syndrome). Option B) is incorrect because placing the infant on their tummy while awake actually encourages the achievement of developmental milestones such as head control, rolling over, and eventually crawling. Option C) is incorrect because while tummy time does support overall motor development, the primary purpose at 3 months is to encourage head control and the ability to turn over. It is not specifically focused on fine motor development at this stage. In an educational context, understanding the importance of tummy time and its role in promoting infant development is crucial for pediatric nurses. By educating parents on the benefits of supervised tummy time, nurses can empower them to actively participate in their child's motor skill development and overall well-being.

Correct Answer: D

Rationale: The correct answer is D) a topical anesthetic, EMLA, can be applied before injections are given. Rationale: - The correct answer emphasizes the use of a topical anesthetic, EMLA, to reduce the discomfort associated with injections for the infant. This approach addresses the mother's concerns while ensuring the child receives necessary immunizations without unnecessary distress. - Option A is incorrect because discomfort associated with injections can be minimized, and preventive measures can be taken to reduce the pain experienced by the infant. - Option B is incorrect as infants do feel pain, although they may express it differently than adults. It is important to acknowledge and address their pain to provide appropriate care. - Option C is incorrect as discomfort alone is not a valid reason to refuse immunizations. The benefits of immunizations far outweigh the temporary discomfort of injections. Educational Context: In pediatric nursing, it is crucial to address parents' concerns about their child's care, including immunizations. Educating parents on pain management strategies, such as using topical anesthetics like EMLA, can help alleviate their fears and ensure compliance with recommended immunization schedules. By providing this education, nurses empower parents to make informed decisions that prioritize their child's health and well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) amphetamine. The presentation of delirium, tachycardia, myoclonus, dilated pupils, seizures, and dysrhythmia is indicative of amphetamine toxicity. Amphetamines are central nervous system stimulants that can cause a spectrum of symptoms ranging from agitation to seizures and cardiac dysrhythmias. Antidepressant agents (option A) typically do not present with the constellation of symptoms described. Barbiturates (option C) usually cause respiratory depression and hypotension, rather than the tachycardia and myoclonus seen in this case. Benzodiazepines (option D) are more likely to cause sedation, respiratory depression, and hypotension rather than the symptoms described. In an educational context, understanding the signs and symptoms of common pediatric poisonings is crucial for nurses working with children. Recognizing the specific toxidrome associated with different substances helps in providing prompt and appropriate care. It is also essential for nurses to educate families about safe medication storage and the risks associated with various substances to prevent accidental ingestions in children.

Correct Answer: C

Rationale: The correct answer is C) spermicides. Spermicides have the highest failure rate even with perfect use due to their lower effectiveness compared to other contraceptive methods. Spermicides alone have a failure rate of around 28% with typical use and 18% with perfect use. Progestin-releasing intrauterine devices (Option A) have a very low failure rate, making them one of the most effective forms of contraception. Progestin-only injections (Option B) also have a high effectiveness rate when used correctly. Male condoms (Option D) have a much lower failure rate compared to spermicides, especially when used consistently and correctly. In an educational context, understanding the effectiveness of different contraceptive methods is crucial for healthcare providers, especially in pediatric nursing. Providing accurate information to adolescents regarding contraceptive options empowers them to make informed decisions about their sexual health. Emphasizing the importance of using contraception consistently and correctly can help prevent unintended pregnancies and sexually transmitted infections among young people.

Correct Answer: B

Rationale: In this scenario, the most likely cause of the sudden drop in O2 saturation when ventilating a full-term baby with meconium aspiration syndrome is option B) endotracheal tube blockade. Endotracheal tube blockade can occur due to the accumulation of meconium or mucus in the tube, leading to inadequate ventilation and oxygenation. Option A) O2 source supply is unlikely to be the cause as the baby was fine on the machine previously. Option C) self-extubation is less likely in a full-term baby with meconium aspiration syndrome as they are typically not able to self-extubate. Option D) low inspiratory pressure value could lead to inadequate ventilation but is less likely to cause a sudden severe drop in O2 saturation. Educationally, it is crucial for pediatric nurses to understand the common complications and challenges in ventilating newborns, especially those with meconium aspiration syndrome. Recognizing and promptly addressing issues like endotracheal tube blockage can be life-saving for these vulnerable patients. Nurses must be skilled in troubleshooting and responding quickly to changes in a baby's condition during ventilation to ensure optimal outcomes.