Nursing Elites

1. In a case where a limb is protruding from a mother's vagina during active labor, how should this condition be managed?

• A. Positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport
• B. Positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport
• C. Applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord
• D. Giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur

Correct answer: B

Rationale: When a limb is protruding from the vagina during active labor, the appropriate management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord, reducing the risk of compromising fetal blood flow and oxygenation. Administering oxygen is essential to maintain oxygenation levels for both the mother and the fetus. Providing transport to a healthcare facility equipped to manage this obstetric emergency is crucial for ensuring a safe delivery. Choice A is incorrect because a semi-Fowler's position does not effectively relieve pressure on the umbilical cord. Choice C is incorrect as applying traction to the protruding limb can lead to injury or complications for both the mother and the fetus. Choice D is incorrect because attempting to manipulate the limb without proper positioning and preparation can worsen the situation and increase risks during delivery.

2. The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?

• A. Shortened prothrombin time
• B. Increased fibrinogen level
• C. Positive fibrin split products
• D. Increased platelets

Correct answer: C

Rationale: Positive fibrin split products are indicative of disseminated intravascular coagulation (DIC). In DIC, there is widespread clotting and subsequent consumption of clotting factors, leading to the formation of fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster clotting, which is opposite to the pathophysiology of DIC. An increased fibrinogen level (Choice B) may be observed in the early stages of DIC due to the compensatory increase in production, but it is not a definitive indicator. Increased platelets (Choice D) may be seen in the early stages of DIC due to the body's attempt to compensate for clot formation, but it is not a specific finding for DIC.

3. The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?

• A. Most childhood cancers affect tissues rather than organs.
• B. Childhood cancers are usually localized when found.
• C. Unlike adult cancers, childhood cancers are less responsive to treatment.
• D. The majority of childhood cancers can be prevented.

Correct answer: A

Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers can be localized or spread, similar to adult cancers. Choice C is incorrect because childhood cancers can be highly responsive to treatment, especially when diagnosed early. Choice D is incorrect because the majority of childhood cancers cannot be prevented as they are often due to genetic mutations or unknown causes.

4. When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to

• A. ask the patient to sign a release form
• B. ask a female EMT-B to attempt to assess the patient
• C. explain to the patient that she must be examined
• D. transport the patient without performing an assessment

Correct answer: B

Rationale: In cases of sexual assault, it is crucial to prioritize the patient's emotional and physical comfort. Asking a female EMT-B to attempt the assessment is the most appropriate initial action as it respects the patient's need for privacy and comfort. Asking the patient to sign a release form (Choice A) is not the immediate concern when the patient's well-being and comfort are at stake. Explaining to the patient that she must be examined (Choice C) disregards her autonomy and can worsen the trauma she is experiencing. Transporting the patient without performing an assessment (Choice D) neglects the necessary evaluation and potentially vital care that she may require.

5. When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?

• A. They may occur in minor illnesses.
• B. The cause is usually readily identified.
• C. They usually do not occur during the toddler years.
• D. The frequency of occurrence is greater in females than males.

Correct answer: A

Rationale: The correct answer is A: 'They may occur in minor illnesses.' Febrile seizures can occur even in minor illnesses, particularly in young children, and are often triggered by a rapid increase in body temperature. Choice B is incorrect because the cause of febrile seizures is not always readily identified. Choice C is incorrect as febrile seizures commonly occur in children between the ages of 6 months to 5 years, which includes the toddler years. Choice D is incorrect as febrile seizures are slightly more common in males than females.

Similar Questions