Nursing Elites

1. 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.

2. Which of the following is MOST likely to occur in conjunction with a breech presentation?

• A. Vertex presentation
• B. Maternal hypertension
• C. Prolapsed umbilical cord
• D. Premature rupture of the amniotic sac

Correct answer: C

Rationale: In a breech presentation, where the baby's buttocks or feet present first, there is an increased risk of the umbilical cord slipping down alongside or below the presenting part, leading to a prolapsed umbilical cord. This is a serious complication that can compromise fetal blood flow and oxygenation, necessitating prompt intervention to prevent adverse outcomes. Choices A, B, and D are less likely to occur in conjunction with a breech presentation. Vertex presentation is the normal head-first presentation, maternal hypertension is a separate condition that may not be directly related to fetal presentation, and premature rupture of the amniotic sac can happen independently of the baby's presentation.

3. What is the appropriate technique for performing two-rescuer CPR on a 4-year-old child?

• A. 15 compressions to 2 ventilations, compressing the sternum with your thumbs, and delivering at least 100 compressions per minute.
• B. 30 compressions to 2 ventilations, compressing the chest one third the depth of the chest, and delivering each breath over 1 second.
• C. 15 compressions to 2 ventilations, compressing the sternum with the heel of your hand, and ventilating until visible chest rise occurs.
• D. 30 compressions to 2 ventilations, compressing the sternum with the heel of both hands, and delivering each breath over 1 to 2 seconds.

Correct answer: C

Rationale: When performing two-rescuer CPR on a 4-year-old child, the appropriate technique involves 15 compressions to 2 ventilations. Compressions should be done by pressing the child's sternum with the heel of your hand. Ventilations should be given until visible chest rise occurs. This technique ensures effective CPR delivery for a child in need of resuscitation.

4. Atta, who weighs 20kg, has been prescribed amoxicillin 500 mg b.i.d. The drug information indicates a daily dose of amoxicillin at 50 mg/kg/day in two divided doses. What is the safest dose in milligrams for this child?

• A. 1000 mg
• B. 750 mg
• C. 500 mg
• D. 250 mg

Correct answer: A

Rationale: To calculate the safest dose of amoxicillin for Atta, we multiply the weight (20kg) by the daily dose (50 mg/kg/day) which equals 1000 mg/day. Since the dose is to be given in two divided doses, the safest dose for each administration would be 500 mg. Therefore, the correct answer is 1000 mg, as it aligns with the prescribed dose for this child based on weight and dosing guidelines. Choice B, 750 mg, is incorrect as it does not match the calculated daily dose. Choice C, 500 mg, is incorrect as it represents the safest dose for each administration, not the total daily dose. Choice D, 250 mg, is incorrect as it is below the calculated daily dose required for the child.

5. Which of the following interventions is NOT appropriate for a hospitalized adolescent?

• A. Allow the adolescent to assist with procedures when possible.
• B. Encourage them to discuss their thoughts and feelings about the hospitalization.
• C. Encourage them to remain in the room throughout the hospitalization to ensure adequate rest periods.
• D. Encourage peer visitation.

Correct answer: C

Rationale: Encouraging the adolescent to remain in the room throughout the hospitalization may lead to social isolation, hinder the adolescent's emotional well-being, and impede their recovery. It is essential for adolescents to have social interaction, engage in meaningful conversations, and receive support from peers to cope with the stress of hospitalization. Choices A, B, and D are appropriate interventions as they promote involvement in care, emotional expression, and social support, which are beneficial for the adolescent's overall well-being during hospitalization.

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