Nursing Elites

1. Your assessment of a 5-year-old child reveals that he is unresponsive with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Treatment for this child should include:

• A. high-flow oxygen via non-rebreathing mask and rapid transport.
• B. assisted ventilation with a bag-mask device and rapid transport.
• C. positive-pressure ventilation, chest compressions, and rapid transport.
• D. back slaps and chest thrusts while attempting artificial ventilations.

Correct answer: C

Rationale: In a 5-year-old child who is unresponsive with severe bradycardia and bradypnea, the priority is to provide positive-pressure ventilation to support breathing and perform chest compressions to support circulation. This child is in cardiac arrest, and the recommended treatment according to pediatric basic life support guidelines involves a combination of positive-pressure ventilation and chest compressions to maintain oxygenation and circulation. Rapid transport to a medical facility for further advanced care is crucial in this critical situation. Choices A, B, and D are incorrect because high-flow oxygen via non-rebreathing mask, assisted ventilation with a bag-mask device, and back slaps with chest thrusts are not sufficient in a cardiac arrest situation where the child requires immediate positive-pressure ventilation and chest compressions to maintain oxygenation and circulation.

2. In the Integrated Management of Neonatal and Childhood Illnesses, one of the things to look for is danger signs. Which of the following will you consider a danger sign in a child?

• A. The child vomits everything
• B. A child with diarrhea
• C. A child with headache
• D. All of the above

Correct answer: A

Rationale: The correct answer is A: 'The child vomits everything.' Vomiting everything is considered a danger sign in a child as it can lead to dehydration and other serious complications. Recognizing this sign early can help in timely intervention and management of the child's condition. Choices B and C are incorrect as diarrhea and headache, while concerning, are not specific danger signs highlighted in the Integrated Management of Neonatal and Childhood Illnesses.

3. 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.

4. A breastfeeding mother is experiencing nipple pain. What should the nurse instruct her to do?

• A. Use soap and water to clean her nipples
• B. Apply warm compresses to her breasts
• C. Ensure the baby is latching on properly
• D. Limit breastfeeding to every 4 hours

Correct answer: C

Rationale: When a breastfeeding mother experiences nipple pain, ensuring the baby latches on properly is essential. Proper latch-on technique can help prevent and alleviate nipple pain by ensuring the baby is effectively extracting milk and not causing undue pressure or friction on the nipple. This guidance can promote a more comfortable breastfeeding experience for the mother and improve milk transfer for the baby.

5. A 5-year-old boy was struck by a car when he ran out into the street. When you arrive at the scene and approach the child, you see him lying supine approximately 15 feet from the car. Based on the child's age and mechanism of injury, which of the following should you suspect to be his PRIMARY injury?

• A. Lower leg injury
• B. Head injury
• C. Upper thorax injury
• D. Pelvic injury

Correct answer: D

Rationale: Given the mechanism of injury and the distance the child was thrown, a primary pelvic injury should be suspected due to the high impact and force. The pelvis is a common site for significant injury in such cases, and the distance the child was thrown indicates a high-energy impact that could lead to pelvic fractures or injuries.

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