Nursing Elites

1. Which of the following statements regarding pediatric anatomy is correct?

• A. The child's trachea is more rigid and less prone to collapse.
• B. The occiput is proportionately larger when compared to an adult.
• C. Airway obstruction is common in children due to their large uvula.
• D. Relative to the overall size of the airway, a child's epiglottis is smaller.

Correct answer: B

Rationale: The occiput, the back part of the head, is proportionately larger in children compared to adults, which can have implications for airway management techniques. This anatomical difference is important to consider when providing care to pediatric patients, especially during airway interventions.

2. Which position is MOST appropriate for a mother in labor with a prolapsed umbilical cord?

• A. Supine with legs elevated
• B. Supine with hips elevated
• C. Left lateral recumbent
• D. Left side with legs elevated

Correct answer: B

Rationale: The most appropriate position for a mother in labor with a prolapsed umbilical cord is supine with hips elevated. This position helps reduce pressure on the cord, preventing further complications and ensuring optimal blood flow to the fetus.

3. What should be the drop rate per minute using a drop factor of 20 drops/ml?

• A. 19 drops/min
• B. 23 drops/min
• C. 36 drops/min
• D. 46.7 drops/min

Correct answer: A

Rationale: To calculate the drop rate per minute when using a drop factor of 20 drops/ml, you simply divide 60 (minutes) by the drop factor (20 drops/ml), giving you 3. Therefore, the drop rate per minute would be 3 drops x 20 drops/ml = 60 drops/min. However, since the question asks for the drop rate using a 20 drops/ml factor, the correct answer is slightly less than 60. By rounding down, the closest option is 19 drops/min, which is the correct calculation when considering the drop factor.

4. During the initial assessment of the newborn, which of the following data would be considered normal?

• A. Chest circumference 31.5 cm, head circumference 33.5 cm
• B. Chest circumference 30 cm, head circumference 29 cm
• C. Chest circumference 38 cm, head circumference 31.5 cm
• D. Chest circumference 32.5 cm, head circumference 36 cm

Correct answer: A

Rationale: The correct answer is A. During the initial assessment of a newborn, the average head circumference at birth is 32 to 37 cm, while the average chest circumference ranges from 30 to 35 cm. Normally, the head's circumference is about 2 cm greater than the chest circumference at birth. Choice A provides measurements of chest circumference 31.5 cm and head circumference 33.5 cm, both falling within the normal range in terms of actual size and relative size. Choices B, C, and D do not align with the typical measurements seen in a healthy newborn. Choice B has both circumferences below the average range, choice C has the chest circumference above the average, and choice D has the head circumference notably higher than the chest circumference, which is not typical for a newborn.

5. How will a ventricular septal defect affect blood flow?

• A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
• B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
• C. No shunting occurs due to high pressure in the left ventricle.
• D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.

Correct answer: A

Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.

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