Nursing Elites

1. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

2. 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.

3. Which pain assessment tool is most appropriate for a 3-month-old hospitalized with a fractured femur?

• A. FLACC scale
• B. Poker chip tool
• C. Number scale
• D. Visual analog scale

Correct answer: A

Rationale: The FLACC scale, which stands for Face, Legs, Activity, Cry, and Consolability, is specifically designed for nonverbal patients like infants and young children. It assesses pain based on observable behaviors such as facial expressions, leg movement, activity level, cry, and the ability to be consoled. In this case, a 3-month-old infant who is unable to communicate verbally would best be assessed using the FLACC scale to determine the level of pain experienced due to a fractured femur. The Poker chip tool, Number scale, and Visual analog scale are not suitable for nonverbal infants and young children as they rely on self-reporting or cognitive abilities that are not yet developed at this age.

4. When does the rash in typhoid fever typically appear?

• A. On the second day after symptoms appear
• B. On the third day after symptoms appear
• C. On the fourth day after symptoms appear
• D. On the seventh day after symptoms appear

Correct answer: B

Rationale: In typhoid fever, the rash typically appears on the third day after symptoms first appear. This rash can help in diagnosing the disease along with other symptoms such as fever, malaise, and abdominal pain. Choices A, C, and D are incorrect because the rash in typhoid fever usually appears on the third day, not the second, fourth, or seventh day after the symptoms begin.

5. 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.

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