Nursing Elites

1. When performing CPR on an infant with suspected sudden infant death syndrome (SIDS), an important aspect to consider is:

• A. Focusing all of your attention on the infant, with minimal parental interaction.
• B. Carefully inspecting the environment in which the infant was found.
• C. Understanding that most infants with SIDS can be successfully resuscitated.
• D. Encouraging the presence of the parents during your resuscitation attempt.

Correct answer: B

Rationale: When dealing with a suspected case of SIDS, it is crucial to carefully inspect the environment in which the infant was found. This inspection can provide valuable information that may help determine the cause and support further investigation into the incident. By examining the surroundings, potential hazards or clues related to the sudden event may be identified, aiding in understanding the circumstances and potentially preventing similar incidents in the future.

2. A new parent is concerned because their newborn's stools are loose and yellow. The healthcare provider should explain that this is:

• A. A sign of dehydration
• B. A normal finding in breastfed infants
• C. Indicative of an infection
• D. Due to lactose intolerance

Correct answer: B

Rationale: Loose, yellow stools are a normal finding in breastfed infants. Breastfed infants often have loose, yellow stools due to the composition of breast milk. It is not typically a sign of dehydration, infection, or lactose intolerance in this context.

3. A mother of a 6-year-old actively playing child, diagnosed with type 1 diabetes mellitus a year ago, calls a clinic nurse and reports that the child has been sick. She checked the child's urine, which was positive for ketones. What should the nurse instruct the mother to do?

• A. Administer an additional dose of regular insulin
• B. Come to the clinic immediately
• C. Encourage the child to drink liquids
• D. Hold the next dose of insulin

Correct answer: C

Rationale: Encouraging the child to drink liquids is essential in managing ketones in urine. Increased fluid intake can help prevent dehydration and aid in flushing out ketones, which is crucial in managing diabetic ketoacidosis, a serious complication of uncontrolled diabetes.

4. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

• A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
• B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
• C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
• D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

5. 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.

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