Nursing Elites

1. You are called to a residence for a 'sick' 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of

• A. 100% oxygen via a non-rebreathing mask and rapid transport
• B. positive pressure ventilations with a BVM device and rapid transport
• C. chest compressions, artificial ventilations, and rapid transport
• D. back blows and chest thrusts while attempting artificial ventilations

Correct answer: C

Rationale: In a 5-year-old child who is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min, the priority is to initiate chest compressions, artificial ventilations, and rapid transport. These vital interventions are crucial in cases of severe respiratory and cardiovascular compromise. Choice A is incorrect because administering 100% oxygen alone may not address the underlying issues of inadequate ventilation and circulatory support. Choice B is not the most appropriate initial intervention in this scenario; chest compressions should precede positive pressure ventilations. Choice D is incorrect as back blows and chest thrusts are indicated in choking emergencies, not in this case of respiratory and cardiovascular compromise.

2. A child with a diagnosis of cystic fibrosis is admitted to the hospital. What is the priority nursing intervention?

• A. Administering pancreatic enzymes
• B. Providing respiratory therapy
• C. Providing nutritional support
• D. Encouraging physical activity

Correct answer: A

Rationale: The correct answer is administering pancreatic enzymes. In cystic fibrosis, there is a deficiency in pancreatic enzymes, leading to poor digestion and malabsorption of nutrients. Administering pancreatic enzymes is essential to ensure proper digestion and absorption of nutrients. Providing respiratory therapy and nutritional support are important aspects of care for a child with cystic fibrosis, but addressing the pancreatic enzyme deficiency takes priority in this scenario. Encouraging physical activity is beneficial for overall health but is not the priority intervention in this case.

3. A child with a diagnosis of congenital heart disease is admitted to the hospital. What should the nurse include in the child’s care plan?

• A. Monitoring fluid status
• B. Encouraging activity
• C. Promoting a high-calorie diet
• D. Maintaining oxygen therapy

Correct answer: A

Rationale: Monitoring fluid status is crucial for a child with congenital heart disease because these children are at risk of fluid overload which can worsen their condition. Monitoring fluid intake and output helps prevent complications like congestive heart failure. Encouraging activity (Choice B) should be individualized based on the child's condition and tolerance, as excessive activity can strain the heart. Promoting a high-calorie diet (Choice C) is not typically recommended for children with congenital heart disease unless specifically indicated, as excessive weight gain can worsen their cardiac function. Maintaining oxygen therapy (Choice D) may be necessary in some cases, but monitoring fluid status is a more fundamental aspect of care for children with congenital heart disease.

4. What behavior does the nurse anticipate when feeding a newborn with choanal atresia?

• A. Chokes during feeding
• B. Experiences swallowing challenges
• C. Lacks hunger cues
• D. Takes about half of the feeding

Correct answer: D

Rationale: When feeding a newborn with choanal atresia, the nurse can anticipate that the infant may take only part of the feeding before pausing for air. This is due to the fact that infants with choanal atresia struggle to breathe through their nose while feeding. Choice A is incorrect as choking typically involves a more severe airway obstruction. Choice B is incorrect because difficulty swallowing is not the primary concern in choanal atresia. Choice C is incorrect as the issue is not related to hunger cues but rather the physiological challenges associated with breathing while feeding.

5. A child with a diagnosis of diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels daily
• B. Administer insulin based on blood glucose levels
• C. Recognize signs of hypoglycemia
• D. Follow a specific meal plan

Correct answer: D

Rationale: For a child with diabetes mellitus, following a specific meal plan is crucial for managing blood glucose levels effectively. This helps in maintaining stable blood sugar levels and preventing complications associated with the condition. Monitoring blood glucose levels daily and recognizing signs of hypoglycemia are also important aspects of managing diabetes; however, adherence to a specific meal plan plays a fundamental role in overall diabetes care. Administering insulin based on blood glucose levels alone is not recommended without a specific plan provided by healthcare providers.

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