Nursing Elites

1. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

• A. begin ventilations with a bag-mask device.
• B. gently flick the soles of their feet for up to 60 seconds.
• C. immediately suction their mouth and nose.
• D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

2. In which of the following situations would the EMT MOST likely deliver a baby at the scene?

• A. A tornado has struck and blocked the only route to the hospital.
• B. Contractions are 8 to 10 minutes apart and irregular.
• C. The amniotic sac has ruptured, and contractions occur regularly.
• D. The hospital is 15 miles away, and crowning is not present.

Correct answer: A

Rationale: The EMT may be required to deliver a baby at the scene when external factors like a tornado have blocked the only route to the hospital, making it impossible to reach the medical facility in time for delivery. In such emergencies, the EMT must be prepared to manage the childbirth process until further medical assistance can be obtained.

3. The healthcare provider assesses the vital signs of a 12-month-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths/minute. Based on this finding, which action is most appropriate?

• A. Administer oxygen
• B. Document the findings
• C. Notify the healthcare provider
• D. Reassess the respiratory rate in 15 minutes

Correct answer: B

Rationale: Documenting the findings is the most appropriate action since a respiratory rate of 35 breaths per minute falls within the normal range for a 12-month-old infant. There is no immediate need for interventions such as administering oxygen or notifying the healthcare provider. Reassessing the respiratory rate in 15 minutes is unnecessary as the rate is within normal limits.

4. Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and takes steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?

• A. Sodium bicarbonate from renal compensation
• B. Potassium from cell death
• C. Glucose from carbohydrate metabolism
• D. Ketone bodies from fat metabolism

Correct answer: D

Rationale: Diabetic ketoacidosis (DKA) results from the excessive accumulation of ketone bodies from fat metabolism. During DKA, there is a lack of insulin leading to the breakdown of fat stores into fatty acids and their subsequent conversion into ketone bodies. These ketone bodies accumulate in the blood, leading to metabolic acidosis and the characteristic symptoms of DKA.

5. Which of the following is NOT an infectious cause of diarrheal diseases?

• A. Allergy
• B. Bacterial
• C. Parasitic
• D. Viral

Correct answer: A

Rationale: Allergy is the correct answer as it is a non-infectious cause of diarrheal diseases. While bacterial, parasitic, and viral infections can lead to diarrhea by affecting the gastrointestinal tract, allergies are immune system reactions triggered by specific substances and are not caused by infectious agents. Bacterial, parasitic, and viral infections are known to cause infectious diarrhea, making choices B, C, and D incorrect.

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