Nursing Elites

1. What is the appropriate ventilation rate for an apneic infant?

• A. 8 to 10 breaths/min.
• B. 10 to 12 breaths/min.
• C. 12 to 20 breaths/min.
• D. 20 to 30 breaths/min.

Correct answer: C

Rationale: During resuscitation of an apneic infant, the appropriate ventilation rate is 12 to 20 breaths per minute. This rate helps provide adequate oxygenation and ventilation without causing harm to the infant. Choice A (8 to 10 breaths/min) is too low and may not provide sufficient ventilation. Choice B (10 to 12 breaths/min) is slightly below the recommended range, which may not be optimal for effective resuscitation. Choice D (20 to 30 breaths/min) is too high and may lead to overventilation and potential harm to the infant by causing hypocapnia.

2. A toddler is admitted to the hospital because of sudden hoarseness, holding or pointing to their neck, and continuous cough. The nurse will be particularly concerned about:

• A. Acute respiratory tract infection
• B. Respiratory tract obstruction caused by a foreign body
• C. Retropharyngeal abscess
• D. Undetected laryngeal abnormality

Correct answer: B

Rationale: In a toddler presenting with sudden hoarseness, holding or pointing to their neck, and continuous cough, the nurse should be particularly concerned about respiratory tract obstruction caused by a foreign body. These symptoms are indicative of a possible foreign body in the airway, which can lead to serious complications and requires immediate attention to ensure the toddler's airway remains patent and unobstructed.

3. You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?

• A. Poison oak exposure
• B. Allergic reaction
• C. Heat illness
• D. Acute asthma attack

Correct answer: B

Rationale: The presentation of wheezing, widespread hives, and facial edema is consistent with an allergic reaction. These symptoms indicate a systemic response to an allergen, triggering respiratory distress and skin manifestations.

4. 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.

5. What comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?

• A. He is always hungry.
• B. He tires out during feedings.
• C. He is fussy for several hours every day.
• D. He sleeps all the time.

Correct answer: B

Rationale: Observing a 1-month-old tiring out during feedings should alert the nurse to the possibility of a congenital heart defect. This symptom may indicate that the infant is expending excess energy to compensate for a heart issue, leading to fatigue during feeding. Choices A, C, and D do not directly relate to a congenital heart defect. Being always hungry, fussy, or sleeping a lot are not specific signs of a congenital heart defect in a 1-month-old.

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