Nursing Elites

1. The Andrews family has been taking good care of their youngest, Archie, who was diagnosed with asthma. Which of the following statements indicate a need for further home care teaching?

• A. He should increase his fluid intake regularly to thin secretions.
• B. We'll make sure he avoids exercise to prevent attacks.
• C. He is to use his bronchodilator inhaler before the steroid inhaler.
• D. We need to identify what triggers his attacks.

Correct answer: B

Rationale: The correct answer is B. Avoiding exercise entirely is not recommended for asthma management. Regular exercise can actually help strengthen the lungs and improve overall respiratory function. Teaching should focus on appropriate exercise routines that are suitable for individuals with asthma to prevent attacks. Choices A, C, and D are all appropriate and indicate good understanding of asthma management. Increasing fluid intake helps thin secretions, using the bronchodilator inhaler before the steroid inhaler follows the correct order of inhaler administration, and identifying triggers is essential for asthma control.

2. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:

• A. placing the child supine and palpating the abdomen.
• B. separating the child from the parent to ensure a reliable examination.
• C. examining the child in the parent's arms.
• D. palpating the painful area of the abdomen first.

Correct answer: C

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.

3. Which pain assessment tool is most appropriate for a 3-month-old hospitalized with a fractured femur?

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

Correct answer: A

Rationale: The FLACC scale, which stands for Face, Legs, Activity, Cry, and Consolability, is specifically designed for nonverbal patients like infants and young children. It assesses pain based on observable behaviors such as facial expressions, leg movement, activity level, cry, and the ability to be consoled. In this case, a 3-month-old infant who is unable to communicate verbally would best be assessed using the FLACC scale to determine the level of pain experienced due to a fractured femur. The Poker chip tool, Number scale, and Visual analog scale are not suitable for nonverbal infants and young children as they rely on self-reporting or cognitive abilities that are not yet developed at this age.

4. 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.

5. Based on the complaints provided by Madam KK, is the child exhibiting danger signs?

• A. Yes
• B. No
• C. I don't know
• D. Yes

Correct answer: A

Rationale: Yes, the child is displaying danger signs with symptoms such as fever and rapid breathing, indicating a potential serious health issue that requires immediate attention. The correct answer is 'Yes' because the symptoms described in Madam KK's complaints align with danger signs that suggest a severe health problem. Choices B and C are incorrect because the symptoms mentioned clearly indicate the presence of danger signs. Choice D is a duplicate of choice A and does not provide a valid alternative.

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