Nursing Elites

1. What is the most likely cause of a sudden onset of respiratory distress in a 5-year-old child with no fever?

• A. Infection of the lower airways.
• B. A progressive upper airway infection.
• C. Inflammation of the upper airway.
• D. A foreign body airway obstruction.

Correct answer: D

Rationale: A sudden onset of respiratory distress in a child without fever is most likely due to a foreign body airway obstruction. This obstruction can rapidly lead to difficulty breathing, stridor, and other signs of respiratory distress without necessarily causing a fever. Prompt recognition and intervention are crucial in such cases to prevent further complications and ensure the child's airway remains clear.

2. You have just delivered a baby girl. Your assessment of the newborn reveals that she has a patent airway, is breathing adequately, and has a heart rate of 130 beats/min. Her face and trunk are pink, but her hands and feet are cyanotic. You have clamped and cut the umbilical cord, but the placenta has not yet delivered. You should:

• A. reassess the newborn every 5 minutes and transport after the placenta delivers.
• B. keep the newborn warm, give oxygen to the mother if needed, and transport.
• C. massage the lower part of the mother's uterus until the placenta delivers.
• D. give the newborn high-flow oxygen via a non-rebreathing mask and transport.

Correct answer: B

Rationale: In this scenario, the appropriate action is to keep the newborn warm, ensure the mother receives oxygen if needed, and prepare for transport. The newborn is showing signs of central cyanosis (hands and feet being cyanotic), which can be due to various reasons, including inadequate oxygenation. Therefore, ensuring warmth and possible oxygen to the mother are important. Additionally, monitoring both the mother and baby during transport is crucial for their well-being.

3. The instructor is teaching a group of new mothers about infant care. Which statement indicates that further teaching is needed?

• A. I should put my baby to sleep on their back.
• B. I can give my baby water if they seem thirsty.
• C. Breastfeeding provides all the nutrients my baby needs.
• D. I should burp my baby after each feeding.

Correct answer: B

Rationale: The correct answer is B. Newborns do not need additional water as breast milk or formula provides all the necessary hydration. Giving water to infants can be harmful and is not recommended as it can interfere with the balance of electrolytes in their bodies. Choice A is correct as placing babies on their back for sleep is the recommended safe sleeping position. Choice C is also correct as breastfeeding does provide all the essential nutrients for babies. Choice D is correct as burping the baby after each feeding helps prevent discomfort from trapped air.

4. A 3-year-old is seen in the clinic and is diagnosed with an ear infection. The father reports that the child was awake several times during the night, crying. The PRIORITY nursing diagnosis for this child is:

• A. Sleep Pattern Disturbance related to pain.
• B. Pain related to ear infection.
• C. Altered Family Processes related to ill child.
• D. Ineffective Thermoregulation Related to Infection

Correct answer: B

Rationale: The priority nursing diagnosis for a child diagnosed with an ear infection and experiencing nighttime awakenings and crying would be 'Pain related to ear infection.' Pain management is crucial to ensure the child's comfort and well-being, which can also impact their sleep patterns. Addressing the pain as a priority can lead to improved sleep and overall recovery for the child.

5. What is the term for a condition where there is a failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children, with 80% of cases being idiopathic? It may present with familial patterns, affecting males more than females.

• A. Cretinism
• B. Growth hormone deficiency
• C. Hypothyroidism
• D. Precocious puberty

Correct answer: B

Rationale: Growth hormone deficiency refers to a condition where there is inadequate production of growth hormone by the pituitary gland. This results in impaired growth in children. While 80% of cases are of unknown cause (idiopathic), some may have familial patterns. It is more common in males than females. Cretinism is a condition of severe hypothyroidism during infancy, not related to growth hormone. Hypothyroidism is a disorder involving low thyroid hormone levels, and precocious puberty is the early onset of puberty. Therefore, the correct answer is 'Growth hormone deficiency.'

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