Nursing Elites

1. When managing Akosua Adepa, an eight-year-old diagnosed with Asthma, the nurse will consider the following as complications EXCEPT:

• A. Cor pulmonale
• B. Respiratory arrest
• C. Respiratory distress
• D. Respiratory failure

Correct answer: C

Rationale: When managing a pediatric patient with asthma, the nurse needs to be vigilant about potential complications. While cor pulmonale, respiratory arrest, and respiratory failure are known complications of asthma, respiratory distress is not typically considered a direct complication. Respiratory distress is more of a symptom or a sign of worsening asthma, indicating the need for immediate intervention to prevent progression to more severe complications.

2. Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include:

• A. high-flow oxygen via non-rebreathing mask and rapid transport.
• B. assisted ventilation with a bag-mask device and rapid transport.
• C. positive-pressure ventilation, chest compressions, and rapid transport.
• D. back slaps and chest thrusts while attempting artificial ventilations.

Correct answer: C

Rationale: In a 5-year-old child who is unresponsive with severe bradycardia and bradypnea, the priority is to provide positive-pressure ventilation to support breathing and perform chest compressions to support circulation. This child is in cardiac arrest, and the recommended treatment according to pediatric basic life support guidelines involves a combination of positive-pressure ventilation and chest compressions to maintain oxygenation and circulation. Rapid transport to a medical facility for further advanced care is crucial in this critical situation. Choices A, B, and D are incorrect because high-flow oxygen via non-rebreathing mask, assisted ventilation with a bag-mask device, and back slaps with chest thrusts are not sufficient in a cardiac arrest situation where the child requires immediate positive-pressure ventilation and chest compressions to maintain oxygenation and circulation.

3. A mother of a 2-year-old child complains that her child has a fever, sore mouth, and red eye. What will be the possible diagnosis?

• A. TB
• B. Meningitis
• C. Measles
• D. Pertussis

Correct answer: C

Rationale: The correct answer is C, Measles. Measles commonly presents with symptoms such as fever, sore mouth, and red eyes. These characteristic symptoms help differentiate measles from the other conditions listed. Tuberculosis (Choice A) typically presents with respiratory symptoms, Meningitis (Choice B) commonly presents with symptoms like headache, neck stiffness, and altered mental status, while Pertussis (Choice D) is characterized by severe coughing spells. Therefore, in this case, the symptoms described align more closely with measles.

4. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

• A. begin ventilations with a bag-mask device.
• B. gently flick the soles of their feet for up to 60 seconds.
• C. immediately suction their mouth and nose.
• D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

5. What advice should a school-age child with type 1 diabetes mellitus follow to prevent hypoglycemia during soccer practice?

• A. Drink a cup of orange juice before soccer practice
• B. Eat twice the amount normally eaten at lunchtime
• C. Take half the amount of prescribed insulin on practice days
• D. Take the prescribed insulin at noontime rather than in the morning

Correct answer: A

Rationale: Drinking orange juice before soccer practice is recommended to prevent hypoglycemia in children with type 1 diabetes. Orange juice contains fast-acting carbohydrates that can quickly raise blood sugar levels if they drop during physical activity. Eating twice the amount normally eaten at lunchtime can lead to hyperglycemia, which is high blood sugar, rather than preventing hypoglycemia. Adjusting insulin doses should only be done under the guidance of a healthcare provider. Taking insulin at noontime rather than in the morning does not directly address preventing hypoglycemia during afternoon soccer practice.

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