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 where an 8-year-old boy was pulled from a swimming pool. When you arrive, a neighbor is performing rescue breathing on the child. After confirming that the child is not breathing, you should:

• A. begin chest compressions and reassess in 2 minutes.
• B. assess for a carotid pulse for no more than 10 seconds.
• C. tell the neighbor to continue rescue breathing as you apply the AED.
• D. ask the neighbor how long the child was submerged under the water.

Correct answer: B

Rationale: In cases of drowning, it is crucial to assess for a carotid pulse for no more than 10 seconds to determine if chest compressions are needed. This quick assessment helps determine the next steps in providing appropriate care to the patient. Performing chest compressions without confirming the need may not be beneficial and could potentially harm the patient if unnecessary.

3. A new parent reports to the nurse that the baby looks cross-eyed several times a day. The nurse teaches the parents that this finding should resolve in how long?

• A. 2 months
• B. 2 weeks
• C. 1 year
• D. 4 months

Correct answer: D

Rationale: Transient strabismus, causing the baby to look cross-eyed, is due to poor neuromuscular control of the eye muscles. This condition typically resolves on its own within 3 to 4 months as the infant's neuromuscular control improves. Parents should be reassured that this is a common and temporary issue in infants. Choice A is incorrect as it is too long for the resolution of transient strabismus. Choice B is incorrect as 2 weeks is too short for resolution. Choice C is incorrect as 1 year is too long for transient strabismus to resolve.

4. The provider is educating the parents of a newborn about circumcision care. Which of the following instructions should be included?

• A. Cleanse the penis with each diaper change using alcohol wipes.
• B. Avoid using petroleum jelly on the circumcision site.
• C. Report any yellowish exudate around the head of the penis.
• D. Use warm water to clean the penis gently during diaper changes.

Correct answer: D

Rationale: The correct instruction for circumcision care is to use warm water to gently clean the penis during diaper changes. Alcohol wipes should be avoided as they can cause irritation. Yellowish exudate around the head of the penis is a normal part of the healing process and does not require reporting unless accompanied by other concerning symptoms. Avoiding petroleum jelly on the circumcision site is important to prevent trapping moisture and bacteria, which can lead to infection.

5. A 3-year-old female has had severe diarrhea and vomiting for 4 days. She is now unresponsive with rapid, shallow respirations and thready radial pulses. Her heart rate is 160 beats/min, and her oxygen saturation is 88%. You should:

• A. Ventilate her with a bag-valve mask.
• B. Start chest compressions.
• C. Administer high-flow oxygen via a non-rebreathing mask.
• D. Place her in the recovery position.

Correct answer: A

Rationale: In a pediatric patient presenting with unresponsiveness, rapid, shallow respirations, thready pulses, high heart rate, and low oxygen saturation, the priority is to ensure adequate oxygenation. Ventilating the child with a bag-valve mask is crucial in this scenario to support her breathing and improve oxygenation, as indicated by her low oxygen saturation and respiratory distress. Starting chest compressions is not indicated as the child has a pulse. Administering high-flow oxygen via a non-rebreathing mask may not be as effective as providing positive pressure ventilation with a bag-valve mask in this situation. Placing her in the recovery position is not appropriate when the child is unresponsive and in respiratory distress.

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