Nursing Elites

1. The healthcare provider assesses a postpartum client who is 1 day post-delivery. Which finding would require immediate intervention?

• A. Lochia rubra with a few small clots
• B. Fundus firm and midline
• C. Temperature of 100.4°F (38°C)
• D. Saturated perineal pad in 15 minutes

Correct answer: D

Rationale: A saturated perineal pad in 15 minutes indicates excessive bleeding, which is abnormal postpartum. This finding could suggest hemorrhage, requiring immediate intervention to prevent further complications like hypovolemic shock. Monitoring and managing postpartum bleeding are crucial to ensure the client's safety and prevent serious consequences.

2. A group of nursing students is discussing trends that influence pediatric health care today. The students' discussion focuses on which trends?

• A. Family-centered care
• B. Evidenced-based practice
• C. Nursing traditions
• D. A and B

Correct answer: D

Rationale: In pediatric health care, family-centered care and evidenced-based practice are crucial trends that impact care delivery. Family-centered care involves involving the family in decision-making and care planning, recognizing their role in the child's well-being. Evidenced-based practice ensures nursing interventions are based on the best available evidence to provide high-quality care to pediatric patients. Nursing traditions, though important, may not encompass the latest advancements in pediatric care. Therefore, choices A and B are correct as they represent current influential trends in pediatric health care.

3. What characteristic indicates that a mass on a newborn's head is a cephalohematoma?

• A. The mass appears on the second day after birth.
• B. The mass grows larger when the newborn cries.
• C. The head appears asymmetrical.
• D. The mass is located on only one side of the head.

Correct answer: A

Rationale: A cephalohematoma typically appears between the first and second days after birth, making choice A the correct answer. It results from blood vessel rupture between a cranial bone and the periosteal membrane. Choices B, C, and D are incorrect because the growth of the mass when the newborn cries, asymmetrical head appearance, or the mass being located on only one side of the head are not specific indicators of a cephalohematoma.

4. What is the MOST appropriate method for assessing a small child's level of responsiveness?

• A. Palpate for a radial pulse.
• B. Shout at the child to see if they respond.
• C. Ask the parent about the child's level of responsiveness.
• D. Tap the child and shout, 'Are you okay?'

Correct answer: D

Rationale: When assessing a small child's level of responsiveness, the most appropriate method is to tap the child and shout, 'Are you okay?' This approach is more likely to elicit a response from the child, providing a direct assessment of their level of consciousness and responsiveness. Palpating for a radial pulse (Choice A) is not the most direct method for assessing responsiveness in a child. Shouting at the child (Choice B) may startle them and not provide an accurate assessment. Asking the parent (Choice C) does not directly evaluate the child's responsiveness.

5. What is the aim of Integrated Management of neonatal and Childhood Illnesses?

• A. Improved case management
• B. Improved family and community practices
• C. None of the above
• D. A & B

Correct answer: D

Rationale: The aim of the Integrated Management of neonatal and Childhood Illnesses is to enhance both case management and family and community practices. By improving case management, healthcare providers can ensure appropriate treatment and care, leading to better outcomes for neonates and children. Enhancing family and community practices can contribute to the prevention, early detection, and overall well-being of children. Choice A is incorrect as the aim is not solely focused on improved case management. Choice B is incorrect as the aim goes beyond just improving family and community practices. Choice C is incorrect as the correct aim involves both improved case management and family/community practices, making choice D the most comprehensive and accurate answer.

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