Nursing Elites

1. Which of the following statements regarding two-rescuer child CPR is correct?

• A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be delivered.
• B. A compression-to-ventilation ratio of 15:2 should be delivered with pauses in compressions to give ventilations.
• C. The chest should be allowed to fully recoil between compressions to optimize venous return.
• D. Compress the chest with one or two hands to a depth equal to one third the diameter of the chest.

Correct answer: D

Rationale: In two-rescuer child CPR, the correct compression depth is one third the diameter of the chest. This depth can be achieved by compressing the chest with one or two hands. It is crucial to follow the correct compression depth guideline to ensure effective chest compressions and circulation during CPR for a child.

2. You are dispatched to a residence for a child with respiratory distress. The child is wheezing and has nasal flaring and retractions. His oxygen saturation is 92%. You should:

• A. place the child in a supine position.
• B. administer high-flow oxygen.
• C. begin chest compressions.
• D. administer low-flow oxygen.

Correct answer: B

Rationale: In a scenario where a child presents with respiratory distress, wheezing, nasal flaring, retractions, and an oxygen saturation of 92%, the appropriate intervention is to administer high-flow oxygen. This helps to improve oxygenation and alleviate the respiratory distress the child is experiencing. Placing the child in a supine position can worsen their condition by affecting their ability to breathe effectively. Chest compressions are not indicated in this case as the child is not in cardiac arrest. Administering low-flow oxygen may not provide adequate oxygenation for a child in respiratory distress with a saturation of 92%. Therefore, the priority is to administer high-flow oxygen to improve oxygen levels and support the child's breathing.

3. 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.

4. Before drying off the newborn after birth, which assessment finding should the healthcare professional document to ensure an accurate gestational rating on the Ballard gestational assessment tool?

• A. Amount and area of vernix coverage
• B. Creases on the sole
• C. Size of the areola
• D. Body surface temperature

Correct answer: A

Rationale: To ensure an accurate gestational rating on the Ballard gestational assessment tool, healthcare professionals should document the amount and area of vernix coverage before drying the newborn. Drying the baby after birth could disturb the vernix, potentially affecting the gestational age assessment. Assessing and documenting the vernix coverage beforehand enables a more precise evaluation using the Ballard gestational assessment tool. Choices B, C, and D are incorrect as they are not directly related to gestational rating on the Ballard assessment tool.

5. Which of the following statements regarding SIDS is correct?

• A. SIDS can occur in premature infants.
• B. It is most commonly a result of child abuse.
• C. Death usually occurs during sleep.
• D. SIDS can be prevented by placing the baby on its back to sleep.

Correct answer: C

Rationale: The correct statement regarding SIDS is that death usually occurs during sleep. Sudden Infant Death Syndrome (SIDS) is the unexpected death of a seemingly healthy infant, typically occurring during sleep. The exact cause of SIDS is not fully understood. While placing the baby on its back to sleep is a recommended preventive measure to reduce the risk of SIDS, it cannot guarantee prevention. Choice A is incorrect as SIDS is not limited to premature infants. Choice B is incorrect as SIDS is not primarily caused by child abuse.

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