Nursing Elites

1. After an advanced airway device has been inserted in a 6-month-old infant in cardiopulmonary arrest, you should deliver ventilations at a rate of:

• A. 10 to 12 breaths/min.
• B. 12 to 20 breaths/min.
• C. 6 to 8 breaths/min.
• D. 8 to 10 breaths/min.

Correct answer: D

Rationale: The appropriate ventilation rate for an infant with an advanced airway is 8 to 10 breaths per minute.

2. When ventilating an apneic 3-year-old child with a bag-valve mask device, what is the MOST important action to take?

• A. Avoid hyperventilation and ensure adequate chest rise.
• B. Squeeze the bag with both hands and use a pediatric mask.
• C. Immediately insert an oropharyngeal airway.
• D. Provide one breath every 3 to 5 seconds.

Correct answer: A

Rationale: When ventilating an apneic child, the most important action is to avoid hyperventilation and ensure adequate chest rise. Hyperventilation can lead to decreased cardiac output and increased intracranial pressure. Adequate chest rise confirms effective ventilation and minimizes the risk of complications. Choice B is incorrect because using both hands to squeeze the bag may not ensure proper ventilation and can lead to complications. Choice C is incorrect as inserting an oropharyngeal airway is not the initial action in ventilating an apneic child with a bag-valve mask. Choice D is incorrect as providing ventilations every 3 to 5 seconds may not be appropriate for effective ventilation in a pediatric patient.

3. A group of nursing students is discussing trends that influence pediatric health care today. The students' discussion focuses on which trends?

• A. Family-centered care
• B. Evidenced-based practice
• C. Nursing traditions
• D. A and B

Correct answer: D

Rationale: In pediatric health care, family-centered care and evidenced-based practice are crucial trends that impact care delivery. Family-centered care involves involving the family in decision-making and care planning, recognizing their role in the child's well-being. Evidenced-based practice ensures nursing interventions are based on the best available evidence to provide high-quality care to pediatric patients. Nursing traditions, though important, may not encompass the latest advancements in pediatric care. Therefore, choices A and B are correct as they represent current influential trends in pediatric health care.

4. A clinic nurse reviews the record of a child just seen by a doctor and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

• A. Pallor
• B. Hyperactivity
• C. Exercise intolerance
• D. Gastrointestinal disturbances

Correct answer: C

Rationale: Aortic stenosis is a condition characterized by the narrowing of the aortic valve, leading to reduced blood flow from the heart to the body. This narrowing restricts the amount of oxygenated blood that can reach various tissues, including muscles. As a result, individuals with aortic stenosis may experience exercise intolerance, as their muscles may not receive an adequate oxygen supply during physical activity. This can manifest as fatigue, shortness of breath, and overall decreased exercise capacity. Pallor (choice A) is a pale appearance that may be seen in anemia or other conditions affecting blood flow but is not specific to aortic stenosis. Hyperactivity (choice B) and gastrointestinal disturbances (choice D) are not typically associated with aortic stenosis.

5. Which of the following is the MOST detrimental effect of gastric distention in infants and children?

• A. Tracheal rupture.
• B. Less effective chest compressions.
• C. Decreased ventilatory volume.
• D. Acute rupture of the diaphragm.

Correct answer: C

Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.

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