Nursing Elites

1. In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?

• A. Central cyanosis
• B. Respiratory rate >70 breaths per minute
• C. Grunting noted on assessment
• D. All of the above

Correct answer: D

Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.

2. A 3-month-old is hospitalized with a fractured femur. The pain assessment tool most appropriate for this child is the:

• A. FLACC scale.
• B. Poker chip tool.
• C. Number scale.
• D. Visual analog scale.

Correct answer: A

Rationale: The FLACC scale is a validated pain assessment tool suitable for infants and young children, including 3-month-olds. It assesses pain based on five categories: Face, Legs, Activity, Cry, and Consolability. Since infants cannot communicate their pain verbally, the FLACC scale is effective in evaluating pain by observing these behavioral indicators. The other options, such as the Poker chip tool, Number scale, and Visual analog scale, are not specifically designed for infants and may not provide accurate pain assessment in this age group.

3. During the pediatric assessment process, which scenario would be the LEAST appropriate for the transition phase?

• A. A parent is available to help keep the child calm.
• B. The child is unstable and needs rapid transport.
• C. You determine that the child's condition is stable.
• D. Your transport time is greater than 30 minutes.

Correct answer: B

Rationale: During a pediatric assessment, the transition phase is a critical period where care is handed over from prehospital providers to the hospital team. If the child is unstable and requires rapid transport, it is not appropriate to delay for a transition phase. In such cases, immediate transport to a higher level of care is paramount to ensure the child's safety and well-being. Choice A is appropriate as having a parent present can help keep the child calm during the transition. Choice C is also appropriate as transitioning a stable child allows for a smoother handover. Choice D, while indicating a longer transport time, does not necessarily affect the need for a transition phase as long as the child's condition remains stable.

4. When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:

• A. Focusing all of your attention on the infant, with minimal parental interaction.
• B. Carefully inspecting the environment in which the infant was found.
• C. Understanding that most infants with SIDS can be successfully resuscitated.
• D. Encouraging the presence of the parents during your resuscitation attempt.

Correct answer: B

Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.

5. Madam Serwaa's 7-month-old baby was admitted to your ward with malnutrition. The child has diarrhea with signs of moderate dehydration but can drink. Which of the following will be the most appropriate fluid for Madam Serwaa's baby?

• A. ORS
• B. Resomal
• C. Rice water
• D. I.V. Ringer's lactate

Correct answer: A

Rationale: For a 7-month-old baby with diarrhea and signs of moderate dehydration who can still drink, the most appropriate fluid is Oral Rehydration Solution (ORS). ORS helps in rehydrating the body and replenishing lost electrolytes, making it essential in managing dehydration due to diarrhea.

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