Nursing Elites

1. When responding to a call for a 2-year-old child who fell from a second-story window, with the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's:

• A. chest.
• B. head.
• C. lower extremities.
• D. abdomen.

Correct answer: B

Rationale: In a scenario where a young child falls from a significant height like a second-story window, the primary injury is more likely to be to the head. This is because young children have proportionately larger head sizes compared to their body, making them more susceptible to head injuries in such falls. The chest (Choice A), lower extremities (Choice C), and abdomen (Choice D) are less likely to sustain the primary injury in this scenario, as the impact of the fall and the child's anatomy predispose the head to be the most affected area.

2. Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines that require regulation of the density of the blood. Which of these is the name for a blood-thinner?

• A. Erythromycin
• B. Tetracycline
• C. Warfarin
• D. Amoxicillin

Correct answer: C

Rationale: Warfarin is a medication commonly used as a blood thinner to prevent blood clot formation. It works by inhibiting the clotting factors in the blood, thereby reducing the risk of clot formation and helping in the management of conditions like congestive heart failure and arrhythmias. Choices A, B, and D are antibiotics and do not have blood-thinning properties like Warfarin.

3. A 7-year-old child named Kanjaga exhibits symptoms like fatigue, slow heart rate, dry skin, slower growth, and delayed puberty. Which of the following is the appropriate diagnosis for this deficiency that slows body processes?

• A. Diabetes
• B. Hypothyroidism
• C. Growth hormone deficiency
• D. Stunted growth

Correct answer: B

Rationale: The appropriate diagnosis for the symptoms described in Kanjaga, a 7-year-old child, is hypothyroidism. Hypothyroidism can lead to symptoms such as fatigue, slow heart rate, dry skin, slower growth, and delayed puberty in children.

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. The client is being taught about perineal care postpartum. Which instruction should the client receive?

• A. Use ice packs to reduce swelling for the first 24 hours.
• B. Apply heat packs immediately after birth to reduce pain.
• C. Avoid using a peri-bottle to cleanse the perineum.
• D. Use tampons to absorb lochia discharge.

Correct answer: A

Rationale: The correct instruction for the client postpartum is to use ice packs to reduce swelling for the first 24 hours. This helps alleviate discomfort and promote healing. Applying heat packs immediately after birth is not recommended as they can increase swelling. A peri-bottle is advised for cleansing the perineum, not to be avoided. Tampons should not be used to absorb lochia discharge as they can increase the risk of infection. Therefore, the use of ice packs is the most appropriate and beneficial instruction for perineal care postpartum.

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