Nursing Elites

1. A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. What is the appropriate compression to ventilation ratio for this child?

• A. 3:01
• B. 30:2
• C. 15:2
• D. 5:1

Correct answer: B

Rationale: The correct compression to ventilation ratio for a single rescuer performing CPR on a child is 30:2. This ratio ensures adequate circulation and oxygenation during CPR. 30 compressions help maintain blood flow, while 2 rescue breaths provide oxygenation. Choice A (3:01) is incorrect as it does not follow the standard CPR guidelines for children. Choice C (15:2) is incorrect as it is the ratio used for adult CPR. Choice D (5:1) is incorrect as it is not the recommended ratio for child CPR.

2. Which of the following drinks is recommended for reconstituting oral rehydration salts?

• A. Water
• B. Fruit juice
• C. Soda
• D. All of the above

Correct answer: A

Rationale: The correct answer is A: Water. Water is the ideal fluid to reconstitute oral rehydration salts because it helps in proper hydration without adding unnecessary sugars or acidity that may be present in fruit juice or soda. Using water ensures the salts are properly dissolved and can effectively rehydrate the individual. Choices B and C are incorrect because fruit juice and soda may contain sugars or acidity that can interfere with the rehydration process and are not recommended for reconstituting oral rehydration salts.

3. In the Integrated Management of Neonatal and Childhood Illnesses, one of the things to look for is danger signs. Which of the following will you consider a danger sign in a child?

• A. The child vomits everything
• B. A child with diarrhea
• C. A child with headache
• D. All of the above

Correct answer: A

Rationale: The correct answer is A: 'The child vomits everything.' Vomiting everything is considered a danger sign in a child as it can lead to dehydration and other serious complications. Recognizing this sign early can help in timely intervention and management of the child's condition. Choices B and C are incorrect as diarrhea and headache, while concerning, are not specific danger signs highlighted in the Integrated Management of Neonatal and Childhood Illnesses.

4. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:

• A. begin positive-pressure ventilations and reassess the child.
• B. lower the extremities and reassess the child.
• C. listen to the lungs with a stethoscope for abnormal breath sounds.
• D. insert a nasopharyngeal airway and increase the oxygen flow.

Correct answer: B

Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.

5. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

• A. The child should be allowed to play because doing so can foster healthy self-esteem
• B. The risk for fractures is increased because GH deficiency results in fragile bones
• C. Activity could aggravate insulin sensitivity, causing hyperglycemia
• D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

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