Nursing Elites

1. What is the priority action for a 2-year-old child with croup presenting with a barking cough and stridor?

• A. Administer a corticosteroid
• B. Obtain a throat culture
• C. Administer nebulized epinephrine
• D. Place the child in an upright position

Correct answer: C

Rationale: The priority action for a 2-year-old child with croup and stridor is to administer nebulized epinephrine. Nebulized epinephrine helps reduce airway swelling, alleviate symptoms, and improve breathing by causing vasoconstriction and reducing upper airway edema. Administering a corticosteroid may be done but is not the priority in this scenario. Obtaining a throat culture is not necessary for the immediate management of croup. Placing the child in an upright position can aid in breathing but is not the priority action when the child is presenting with stridor.

2. The caregiver is providing discharge instructions to the parents of a 6-month-old infant who was hospitalized for bronchiolitis. Which statement by the parents indicates a correct understanding of the instructions?

• A. We should keep our baby away from people with colds
• B. We should continue giving the prescribed medication even if our baby seems better
• C. We should avoid giving solid foods to help with recovery
• D. We can place our baby to sleep on their back to help with breathing

Correct answer: A

Rationale: Keeping the infant away from people with colds is crucial to prevent the spread of respiratory infections, especially for infants recently hospitalized with bronchiolitis. This precaution helps protect the baby from further illnesses and promotes recovery. The other choices are incorrect because it is important to complete the prescribed medication course even if the baby seems better to ensure the infection is fully treated (Choice B). Solid foods are usually introduced around six months of age, so avoiding them entirely may not be necessary (Choice C). Placing the baby to sleep on their back is a safe sleep practice to prevent sudden infant death syndrome (SIDS) but may not directly help with breathing in the context of bronchiolitis (Choice D).

3. A 2-year-old girl is brought to the clinic by her 17-year-old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother?

• A. A 2-year-old should be speaking in 2-word phrases
• B. Dental caries is associated with drinking soda
• C. Drinking soda is related to childhood obesity
• D. Toddlers should be sleeping 10 hours a night

Correct answer: B

Rationale: Dental caries are a common concern when children consume sweetened sodas regularly.

4. A 16-year-old male client who has been treated in the past for a seizure disorder is admitted to the hospital. Immediately after admission, he begins to have a grand mal seizure. Which action should the nurse take?

• A. Obtain assistance in holding him to prevent injury.
• B. Observe him carefully.
• C. Call a CODE.
• D. Place a padded tongue blade between the teeth.

Correct answer: B

Rationale: During a grand mal seizure, the priority action for the nurse is to ensure the safety of the client. Observing the client carefully allows the nurse to monitor the seizure activity, the client's breathing, and any signs of distress without interfering with the seizure process. Restraining the client or placing objects in the mouth can lead to injury and should be avoided. Calling a CODE is not appropriate for a seizure as it is a normal response to the client's condition.

5. The healthcare provider finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the infant is still not breathing, which action should the provider take?

• A. Palpate femoral pulse and check for regularity.
• B. Deliver cycles of 30 chest compressions and 2 breaths.
• C. Give two breaths that make the chest rise.
• D. Feel the carotid pulse and check for adequate breathing.

Correct answer: C

Rationale: In pediatric basic life support, for an unresponsive infant who is not breathing normally, the correct action is to give two breaths that make the chest rise. This helps provide oxygen to the infant's body and is a crucial step in resuscitation efforts for infants in distress. Choices A, B, and D are incorrect. Palpating the femoral pulse or feeling the carotid pulse is not indicated in this scenario where the infant is unresponsive and not breathing. Delivering cycles of chest compressions and breaths is not the immediate action to take; the priority is to provide two breaths to help with oxygenation.

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