Nursing Elites

1. When inserting an oropharyngeal airway in a small child, what is the preferred method?

• A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
• B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
• C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
• D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.

Correct answer: C

Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.

2. A new parent is concerned because their newborn's stools are loose and yellow. The healthcare provider should explain that this is:

• A. A sign of dehydration
• B. A normal finding in breastfed infants
• C. Indicative of an infection
• D. Due to lactose intolerance

Correct answer: B

Rationale: Loose, yellow stools are a normal finding in breastfed infants. Breastfed infants often have loose, yellow stools due to the composition of breast milk. It is not typically a sign of dehydration, infection, or lactose intolerance in this context.

3. Why is a prolapsed umbilical cord dangerous?

• A. The cord may be wrapped around the baby's neck, causing strangulation.
• B. The cord might pull the placenta from the uterine wall during delivery.
• C. The baby's head may compress the cord, cutting off its supply of oxygen.
• D. The mother may die of hypoxia due to compromised placental blood flow.

Correct answer: C

Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.

4. Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines that require regulation of the density of the blood. Which of these is the name for a blood-thinner?

• A. Erythromycin
• B. Tetracycline
• C. Warfarin
• D. Amoxicillin

Correct answer: C

Rationale: Warfarin is a medication commonly used as a blood thinner to prevent blood clot formation. It works by inhibiting the clotting factors in the blood, thereby reducing the risk of clot formation and helping in the management of conditions like congestive heart failure and arrhythmias. Choices A, B, and D are antibiotics and do not have blood-thinning properties like Warfarin.

5. 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.

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