Nursing Elites

1. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?

• A. Assess the newborn's skin condition and color.
• B. Initiate positive-pressure ventilations.
• C. Start chest compressions and contact medical control.
• D. Provide blow-by oxygen with oxygen tubing.

Correct answer: B

Rationale: In a newborn with a heart rate below 100 beats/min, the most appropriate initial management is to initiate positive-pressure ventilations. This helps support the newborn's respiratory effort and oxygenation in the setting of a low heart rate, ensuring adequate oxygen supply to vital organs. Assessing the skin condition and color, starting chest compressions, or providing blow-by oxygen are not the priority in this scenario where respiratory support is crucial.

2. A new mother is learning to breastfeed her newborn. Which position is recommended for a mother recovering from a cesarean section?

• A. Cradle hold
• B. Football hold
• C. Side-lying position
• D. Cross-cradle hold

Correct answer: B

Rationale: The football hold is recommended for mothers recovering from a cesarean section because it positions the baby higher up and away from the incision site, avoiding pressure on the abdomen. This hold also provides better support for the baby's head and neck, making it a more comfortable position for both the mother and the newborn.

3. 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.

4. During the pediatric assessment process, which scenario would be the LEAST appropriate for the transition phase?

• A. A parent is available to help keep the child calm.
• B. The child is unstable and needs rapid transport.
• C. You determine that the child's condition is stable.
• D. Your transport time is greater than 30 minutes.

Correct answer: B

Rationale: During a pediatric assessment, the transition phase is a critical period where care is handed over from prehospital providers to the hospital team. If the child is unstable and requires rapid transport, it is not appropriate to delay for a transition phase. In such cases, immediate transport to a higher level of care is paramount to ensure the child's safety and well-being. Choice A is appropriate as having a parent present can help keep the child calm during the transition. Choice C is also appropriate as transitioning a stable child allows for a smoother handover. Choice D, while indicating a longer transport time, does not necessarily affect the need for a transition phase as long as the child's condition remains stable.

5. A nurse provides medication instructions to a first-time mother. Which statement made by the mother indicates a need for further instructions?

• A. I should mix the medication in the baby food and give it when I feed the child
• B. I should administer the oral medication sitting in an upright position and with the head elevated
• C. I will give my child a toy after giving the medication
• D. I will offer my child a juice drink after swallowing the medication

Correct answer: A

Rationale: Mixing medication in baby food is not recommended as it can alter the taste and the child may refuse food.

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