Nursing Elites

1. What is the MOST effective way to prevent cardiopulmonary arrest in a newborn?

• A. Ensure effective oxygenation and ventilation.
• B. Administer blow-by oxygen as soon as the newborn is born.
• C. Perform an Apgar assessment every 5 minutes.
• D. Suction the newborn's mouth and nose every 3 minutes.

Correct answer: A

Rationale: The most effective way to prevent cardiopulmonary arrest in a newborn is to ensure effective oxygenation and ventilation. This is crucial in maintaining adequate oxygen supply and preventing respiratory distress or failure, which are significant factors leading to cardiopulmonary arrest. Providing appropriate ventilation support and oxygenation can help sustain the newborn's vital functions and reduce the risk of cardiopulmonary compromise.

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. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

4. You are dispatched to a residence where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should:

• A. begin chest compressions and reassess in 2 minutes.
• B. assess for a carotid pulse for no more than 10 seconds.
• C. tell the neighbor to continue rescue breathing as you apply the AED.
• D. ask the neighbor how long the child was submerged under the water.

Correct answer: B

Rationale: In cases of drowning, it is crucial to assess for a carotid pulse for no more than 10 seconds to determine if chest compressions are needed. This quick assessment helps determine the next steps in providing appropriate care to the patient. Performing chest compressions without confirming the need may not be beneficial and could potentially harm the patient if unnecessary.

5. A mother visited your facility with the complaint of her child passing watery stools for two days. This is the first time the child is having such an experience. How will you describe such a visit?

• A. Initial
• B. Follow-up
• C. Routine visit
• D. None of the above

Correct answer: A

Rationale: The correct answer is 'Initial.' This visit is described as initial because it is the first time the child is experiencing these symptoms. It signifies the first encounter with healthcare professionals for this specific issue, distinguishing it from subsequent visits which would be follow-up appointments to monitor progress or routine visits for preventive care. Choice B, 'Follow-up,' is incorrect as it implies subsequent visits after the initial encounter. Choice C, 'Routine visit,' is also incorrect as it implies a scheduled visit for preventive care rather than a visit prompted by a new or acute issue. Choice D, 'None of the above,' is incorrect as one of the options accurately describes the situation, which is 'Initial.'

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