Nursing Elites

1. A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?

• A. Liver
• B. Kidney
• C. Pancreas
• D. Spleen

Correct answer: D

Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.

2. A mother visited your facility with the complaint of her child passing watery stools for two days. This is the first time the child is having such an experience. How will you describe such a visit?

• A. Initial
• B. Follow-up
• C. Routine visit
• D. None of the above

Correct answer: A

Rationale: The correct answer is 'Initial.' This visit is described as initial because it is the first time the child is experiencing these symptoms. It signifies the first encounter with healthcare professionals for this specific issue, distinguishing it from subsequent visits which would be follow-up appointments to monitor progress or routine visits for preventive care. Choice B, 'Follow-up,' is incorrect as it implies subsequent visits after the initial encounter. Choice C, 'Routine visit,' is also incorrect as it implies a scheduled visit for preventive care rather than a visit prompted by a new or acute issue. Choice D, 'None of the above,' is incorrect as one of the options accurately describes the situation, which is 'Initial.'

3. Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines that require regulation of the density of the blood. Which of these is the name for a blood-thinner?

• A. Erythromycin
• B. Tetracycline
• C. Warfarin
• D. Amoxicillin

Correct answer: C

Rationale: Warfarin is a medication commonly used as a blood thinner to prevent blood clot formation. It works by inhibiting the clotting factors in the blood, thereby reducing the risk of clot formation and helping in the management of conditions like congestive heart failure and arrhythmias. Choices A, B, and D are antibiotics and do not have blood-thinning properties like Warfarin.

4. A breastfeeding mother reports to the nurse that her newborn nurses every hour and never seems satisfied. Which advice should the nurse provide?

• A. Supplement breastfeeding with formula after each nursing session.
• B. Allow the newborn to nurse on each breast for at least 20 minutes.
• C. Reduce the number of nursing sessions to every 2-3 hours.
• D. Ensure the newborn has a proper latch and is effectively nursing.

Correct answer: D

Rationale: The nurse should ensure that the newborn has a proper latch and is effectively nursing. Sometimes, newborns nurse frequently for comfort even when they are effectively latched. It is essential to address the latch first before considering other interventions. Supplementing with formula (Choice A) may decrease the mother's milk supply. Allowing the newborn to nurse for a set time (Choice B) may not address the underlying latch issue. Reducing nursing sessions (Choice C) may lead to decreased milk production and does not address the latch problem.

5. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

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