Nursing Elites

1. What are the MOST important initial steps in assessing and managing a newborn?

• A. Drying and warming the infant, obtaining an APGAR score.
• B. Clearing the airway, keeping the infant warm.
• C. Suctioning the airway, obtaining a heart rate.
• D. Keeping the infant warm, counting respirations.

Correct answer: B

Rationale: The most crucial initial steps in assessing and managing a newborn involve clearing the airway to ensure proper breathing and keeping the infant warm to maintain body temperature. Airway clearance helps prevent respiratory distress, while warmth is essential to prevent hypothermia, a common issue in newborns. These steps are vital in the immediate care of a newborn to support their transition to extrauterine life and ensure their well-being. Choice A is incorrect because obtaining an APGAR score is important but not as critical as clearing the airway. Choice C is incorrect as suctioning the airway is not always necessary and obtaining a heart rate is secondary to ensuring a clear airway and warmth. Choice D is incorrect because counting respirations is not as immediate and crucial as clearing the airway.

2. When preventing cardiac arrest in infants and small children, the primary focus should be on:

• A. Providing immediate transport.
• B. Ensuring adequate ventilation.
• C. Keeping the child warm.
• D. Avoiding upsetting the child.

Correct answer: B

Rationale: The correct approach to prevent cardiac arrest in infants and small children is to ensure adequate ventilation. In these cases, maintaining proper oxygenation and ventilation is crucial for sustaining life. Providing immediate transport, keeping the child warm, or avoiding upsetting the child are important considerations but ensuring adequate ventilation takes precedence in preventing cardiac arrest and supporting the child's vital functions.

3. Which of the following are clinical types of diarrhoea EXCEPT?

• A. Acute watery
• B. Bloody diarrhoea
• C. Persistent diarrhoea
• D. Secretory diarrhoea

Correct answer: D

Rationale: Secretory diarrhoea is not a clinical type but a distinct mechanism of diarrhoea characterized by increased electrolyte secretion. Acute watery, bloody, and persistent diarrhoea are recognized clinical types associated with different underlying causes and pathophysiologies. Acute watery diarrhoea is common in infectious gastroenteritis, bloody diarrhoea can be caused by inflammatory conditions or infections, and persistent diarrhoea typically lasts for more than 14 days due to various reasons like infections, malabsorption, or inflammatory bowel diseases.

4. You and your partner are performing CPR on a 2-year-old female in cardiac arrest. During your resuscitation attempt, you should:

• A. hyperventilate her due to severe hypoxia.
• B. attach the AED pads after 5 minutes of high-quality CPR.
• C. perform compressions and ventilations at a ratio of 30:2.
• D. allow the chest to fully recoil between compressions.

Correct answer: D

Rationale: Allowing the chest to fully recoil between compressions is crucial during CPR to ensure proper blood flow. This action allows the heart to refill with blood, enhancing the effectiveness of compressions and circulation. Hyperventilating the patient can lead to decreased cardiac output and is not recommended. Attaching AED pads should be done as soon as possible in a pediatric cardiac arrest situation, ideally within 2 minutes. The correct compression-to-ventilation ratio for pediatric CPR is 30:2, focusing on high-quality compressions to provide adequate perfusion to vital organs.

5. The provider is educating the parents of a newborn about circumcision care. Which of the following instructions should be included?

• A. Cleanse the penis with each diaper change using alcohol wipes.
• B. Avoid using petroleum jelly on the circumcision site.
• C. Report any yellowish exudate around the head of the penis.
• D. Use warm water to clean the penis gently during diaper changes.

Correct answer: D

Rationale: The correct instruction for circumcision care is to use warm water to gently clean the penis during diaper changes. Alcohol wipes should be avoided as they can cause irritation. Yellowish exudate around the head of the penis is a normal part of the healing process and does not require reporting unless accompanied by other concerning symptoms. Avoiding petroleum jelly on the circumcision site is important to prevent trapping moisture and bacteria, which can lead to infection.

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