Question

A nurse is teaching mothers on sudden infant death syndrome (SIDS). Which of the following risk factors should be included in the teaching? Select all that apply

Answer 1

Correct Answers:

Co-sleeping with the infant
Nicotine exposure during pregnancy
Covering the infant with soft bedding

Rationale :

🛏️Co-sleeping increases the risk of accidental suffocation or overlaying, which is strongly associated with SIDS.

🚬Nicotine exposure during pregnancy disrupts fetal development and affects autonomic control of breathing, significantly increasing SIDS risk.

🧸Soft bedding, such as pillows or blankets, can block the infant’s airway and should be avoided, especially during sleep.

🛌While supine sleeping is the recommended position to reduce SIDS and post-datism is not a direct risk factor, the listed correct answers represent modifiable dangers.

📌Core Message

Avoid co-sleeping, maternal smoking, and soft bedding to reduce SIDS risk.

Answer 2

Correct Answers:

Rear-facing in the back seat.

Rationale :

🚗The safest position for infants and toddlers is rear-facing in the back seat, as this provides optimal head, neck, and spine support during collisions.

💺Placing the child in the front seat, regardless of orientation, increases injury risk due to airbag deployment.

📏Rear-facing positions are recommended until at least 2 years old or until the child exceeds the car seat manufacturer’s height/weight limits.

🛡️This positioning follows AAP guidelines for child passenger safety.

📌Core Message

Rear-facing in the back seat is the safest car seat position for infants and toddlers.

Answer 3

Correct Answers:

Congenital dermal melanocytosi

Rationale :

🔵The image shows blue-grey pigmented patches on the infant’s lower back, which are characteristic of congenital dermal melanocytosis (previously known as Mongolian spots).

🧬These macules result from melanocytes trapped in the dermis during fetal development and are benign.

📋They are most common in infants of African, Asian, or Native American descent and typically fade over time.

🩺They must be documented at birth to prevent misinterpretation as bruises from abuse.

📌Core Message

Congenital dermal melanocytosis is a harmless, blue-grey macule seen in many newborns, often mistaken for trauma but requiring only documentation.

Answer 4

Correct Answers:

Measles, mumps, and rubella (MMR) vaccine
Varicella vaccine
Rotavirus vaccine

Rationale :

🚫Children with a CD4 count <200 are considered severely immunocompromised, and live vaccines are contraindicated due to infection risk.

💉MMR, varicella, and rotavirus are live-attenuated vaccines and should not be given in this situation.

💊Meningococcal and hepatitis B are inactivated vaccines and are safe for immunocompromised children.

🦠Live vaccines can cause systemic infection in children with weakened immune systems.

📌Core Message

Avoid live vaccines like MMR, varicella, and rotavirus when CD4 count is low.

Answer 5

Correct Answers:

Gently pull the pinna downwards and backward before administering the ear drops.

Rationale :

👶For children under 3 years old, the ear canal is straighter, so the pinna should be pulled down and back to facilitate proper drop entry.

💦Warming ear drops slightly by rolling them in the hands is acceptable, but using the microwave can lead to overheating and injury.

🛏️Supine positioning is not preferred as it might allow the medication to leak out instead of reaching the canal.

🩺Proper technique ensures effective medication delivery and avoids discomfort.

📌Core Message

For infants and toddlers, pull the pinna down and back to instill ear drops properly.

Answer 6

Correct Answers:

Nebulize with albuterol
Administer oxygen 1 L/min via nasal prongs
Monitor vital signs 2 hourly
Place the child in a semi-Fowler's position

Rationale :

💨Albuterol is a first-line bronchodilator for relieving bronchospasm in acute asthma.

💁‍♂️Oxygen therapy helps correct hypoxemia, as the child’s saturation is below normal.

📈Monitoring vitals is essential during asthma treatment to detect deterioration.

🛏️Semi-Fowler's position optimizes lung expansion and improves ventilation.

🚫Deep breathing exercises are inappropriate during severe distress and may worsen fatigue.

📌Core Message

Start with oxygen, bronchodilators, monitoring, and positioning to treat asthma exacerbations.

Answer 7

Correct Answers:

Nebulize with albuterol

Rationale :

💨Albuterol acts immediately to relax bronchial muscles and reduce wheezing and dyspnea.

📉The child’s O2 sat is 92%, and they’re in moderate distress, so bronchodilator therapy is the top priority.

💊Prednisolone is helpful but takes hours to exert anti-inflammatory effects, so it's not first.

🥤Oral fluids and comfort measures should follow once respiratory stability is achieved.

📌Core Message

In acute asthma, prioritize rapid bronchodilation with albuterol.

Answer 8

Correct Answers:

Continue to monitor the child's respiratory status every 15 minutes.

Rationale :

💁‍♂️The child is improving (lower RR, better O2 sat), but still using accessory muscles and wheezing—indicating ongoing airway inflammation.

👁️Continued frequent monitoring ensures quick detection of deterioration or need for another albuterol dose.

🚪The child is not yet stable for discharge, and no new interventions are immediately required.

📋Ongoing evaluation is crucial after initial improvement in asthma cases.

📌Core Message

After initial response, continue frequent monitoring to ensure sustained improvement.

Answer 9

Correct Answers

Oxygen saturation [ Improved ]
Ability to speak [ Improved ]
Level of consciousness [ Not changed ]
Respiration rate [ Improved ]
Heart rate [ Improved ]
Temperature [ Declined ]

Rationale :

💁‍♂️The oxygen saturation improved from 92% to 96%, reflecting better pulmonary gas exchange.

🗣️The child gained the ability to speak in full sentences, indicating reduced respiratory effort and improved airway patency.

🧠The child remained alert throughout, showing no change in neurological status.

📉The respiratory rate decreased from 45/min to 26/min, which is within a normal range for age and indicates less respiratory distress.

💓The heart rate lowered from 126 bpm to 106 bpm, reflecting reduced sympathetic stimulation.

🌡️The temperature slightly declined, which may indicate stabilization or reduced metabolic stress.

📌Core Message

The child’s oxygenation, respiratory effort, and vital signs show improvement, while neurologic status remains unchanged.

Answer 10

Correct Answers:

"l will let my child play with his cat before bed."
"l will increase the inhaler dose to 3 puffs when my child has a cold."
"l will not allow my child to play with his friends to prevent exacerbations."

Rationale :

🐱Exposure to pet dander, such as from cats, can trigger asthma symptoms, especially at bedtime when lying down.

💊Increasing medication dose without provider approval is dangerous and can lead to overuse side effects or ineffectiveness.

🚫Restricting social interaction unnecessarily can lead to psychosocial issues; instead, focus on trigger avoidance and management.

🥤Encouraging fluids and notifying the provider of breathing difficulty are appropriate and indicate correct understanding.

📌Core Message

Avoid asthma triggers, don’t self-adjust medications, and maintain safe social interaction.

Assessment finding	Improved	Not changed	Declined
Oxygen saturation
Ability to speak
Level of consciousness
Respiration rate
Heart rate
Temperature

NCLEX-RN Practice Exam 3

No.

1 :
A nurse is teaching mothers on sudden infant death syndrome (SIDS). Which of the following risk factors should be included in the teaching? Select all that apply

2 :
A nurse is educating an infants caregiver on car seat safety. Which of the following positions is appropriate?

3 :
A nurse is assessing a child and notices a flat, blue-grey pigmented macule on the back. Which condition can be associated with the image below?

4 :
A nurse is preparing to vaccinate a child with a CD4 count of 150 cells/mm³_.Which vaccines are contraindicated for this client? Select all that apply.

5 :
A nurse is planning care for a I-year-old client with acute otitis media. Which is the proper technique when instilling ear drops?

6 :
A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

7 :
A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

8 :
A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

9 :
A nurse is caring for a 4-year-old child in the emergency department.

Correct Answers

10 :
A nurse is caring for a 4-year-old child in the emergency department.

Answer Options

NCLEX-RN Practice Exam 3

No.

1 : A nurse is teaching mothers on sudden infant death syndrome (SIDS). Which of the following risk factors should be included in the teaching? Select all that apply

2 : A nurse is educating an infants caregiver on car seat safety. Which of the following positions is appropriate?

3 : A nurse is assessing a child and notices a flat, blue-grey pigmented macule on the back. Which condition can be associated with the image below?

4 : A nurse is preparing to vaccinate a child with a CD4 count of 150 cells/mm3. Which vaccines are contraindicated for this client? Select all that apply.

5 : A nurse is planning care for a I-year-old client with acute otitis media. Which is the proper technique when instilling ear drops?

6 : A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

7 : A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

8 : A nurse is caring for a 4-year-old client in the emergency department.

Answer Options

9 : A nurse is caring for a 4-year-old child in the emergency department.

Correct Answers

10 : A nurse is caring for a 4-year-old child in the emergency department.

Answer Options

1 :
A nurse is teaching mothers on sudden infant death syndrome (SIDS). Which of the following risk factors should be included in the teaching? Select all that apply

2 :
A nurse is educating an infants caregiver on car seat safety. Which of the following positions is appropriate?

3 :
A nurse is assessing a child and notices a flat, blue-grey pigmented macule on the back. Which condition can be associated with the image below?

4 :
A nurse is preparing to vaccinate a child with a CD4 count of 150 cells/mm³_.Which vaccines are contraindicated for this client? Select all that apply.

5 :
A nurse is planning care for a I-year-old client with acute otitis media. Which is the proper technique when instilling ear drops?

6 :
A nurse is caring for a 4-year-old client in the emergency department.

7 :
A nurse is caring for a 4-year-old client in the emergency department.

8 :
A nurse is caring for a 4-year-old client in the emergency department.

9 :
A nurse is caring for a 4-year-old child in the emergency department.

10 :
A nurse is caring for a 4-year-old child in the emergency department.