Nursing Elites

1. What is the MOST common cause of shock in infants and children?

• A. Severe allergic reaction
• B. Dehydration
• C. Accidental poisoning
• D. Cardiac failure

Correct answer: B

Rationale: Dehydration is the most common cause of shock in infants and children. In children, the body's fluid reserves are smaller compared to adults, making them more susceptible to dehydration, which can lead to shock if not promptly addressed. Severe allergic reactions, accidental poisoning, and cardiac failure can also cause shock, but dehydration is the most frequent cause in this age group.

2. After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?

• A. A balance of rest and exercise is important.
• B. I can apply lotion or powder to the incision if it is itchy.
• C. Activities in which falling could occur need to be avoided for two to four weeks.
• D. Large crowds of people need to be avoided for at least two weeks after the surgery.

Correct answer: B

Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.

3. During transport of a woman in labor, the patient tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What should you do?

• A. Ask the mother to take short, quick breaths until you arrive at the hospital.
• B. Allow the head to deliver and check for the location of the cord.
• C. Apply gentle pressure to the baby's head and notify the hospital immediately.
• D. Advise your partner to stop the ambulance and assist with the delivery.

Correct answer: D

Rationale: When the top of the baby's head is visible (crowning) during transport, it indicates imminent delivery. In this situation, it is crucial to stop the ambulance and assist with the delivery. This ensures a safe delivery process for the mother and the baby. Waiting to arrive at the hospital or attempting to apply pressure to the baby's head can lead to complications. Allowing the head to deliver and checking for the cord's location is a necessary step during the delivery process, but the immediate priority is to assist in the safe delivery of the baby.

4. What is the reason for Asthma in 4-year-old Mabele, as Mrs. Joyce Thomson inquires? How would you explain it?

• A. Asthma occurs due to inflammation of the respiratory tract triggered by infections.
• B. An asthmatic attack can occur when the child is exposed to certain allergens, triggering an allergic reaction in the bronchioles that causes bronchial constriction.
• C. An asthmatic attack is a response to the release of inflammatory mediators to epithelial cells, affecting the autonomic neural control of the airway.
• D. Asthma is not an inborn problem; it involves abnormal growth of the bronchial tree causing restriction.

Correct answer: B

Rationale: Asthma in children like Mabele can be triggered by exposure to allergens, leading to an allergic reaction in the bronchioles. This reaction causes constriction of the bronchial tree, resulting in an asthmatic attack. It is essential for caregivers to identify and minimize exposure to these triggers to manage and prevent asthma episodes effectively.

5. Which of the following is the MOST detrimental effect of gastric distention in infants and children?

• A. Tracheal rupture.
• B. Less effective chest compressions.
• C. Decreased ventilatory volume.
• D. Acute rupture of the diaphragm.

Correct answer: C

Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.

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