Nursing Elites

1. The healthcare provider is providing postpartum care to a client who had a vaginal delivery. Which finding would require further assessment?

• A. Perineal swelling
• B. Moderate lochia serosa
• C. Headache unrelieved by analgesics
• D. Breast engorgement

Correct answer: C

Rationale: A headache unrelieved by analgesics can be a sign of a serious condition such as preeclampsia, which is a life-threatening condition characterized by high blood pressure and often protein in the urine. Prompt assessment and intervention are crucial to prevent complications for both the mother and baby.

2. After the baby's head delivers, how is it usually tilted?

• A. with the face up.
• B. anteriorly, with the chin up.
• C. posteriorly, to one side.
• D. posteriorly, face down.

Correct answer: C

Rationale: After the baby's head delivers, it is typically tilted posteriorly to one side to help facilitate the delivery of the shoulders. This positioning is important for the safe and smooth delivery of the baby.

3. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:

• A. allowing the parents to transport the child.
• B. offering oxygen and providing transport.
• C. rapidly cooling the child in cold water.
• D. keeping the child warm and providing transport.

Correct answer: B

Rationale: After a febrile seizure, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.

4. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

• A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
• B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
• C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
• D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

5. When is a newborn considered premature?

• A. Weighs less than 6.5 pounds.
• B. Is born to a heroin-addicted mother.
• C. Is born before 37 weeks gestation.
• D. Has meconium in or around its mouth.

Correct answer: C

Rationale: A newborn is considered premature if it is born before 37 weeks gestation. Premature birth increases the risk of various health problems as the baby may not be fully developed. Choice A is incorrect because the weight alone does not determine prematurity. Choice B is incorrect as it refers to a specific situation but not a direct indicator of prematurity. Choice D is incorrect as the presence of meconium does not solely indicate prematurity.

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