Nursing Elites

1. A 3-year-old female presents with respiratory distress. She is conscious, crying, and clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 93%. The MOST effective way of delivering oxygen to her involves:

• A. gently restraining her and assisting with ventilations.
• B. ventilations with a flow-restricted, oxygen-powered device.
• C. a non-rebreathing mask with the flow rate set at 6 to 8 L/min.
• D. asking the mother to hold an oxygen mask near her face.

Correct answer: C

Rationale: In a pediatric patient with respiratory distress, a non-rebreathing mask with a flow rate set at 6 to 8 L/min is the most effective way to deliver oxygen. This method ensures a high concentration of oxygen is delivered to the child, aiding in improving oxygen saturation levels. In this scenario, the mother can assist in holding the mask to maintain comfort and cooperation in the child while ensuring proper oxygen delivery.

2. In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?

• A. Central cyanosis
• B. Respiratory rate >70 breaths per minute
• C. Grunting noted on assessment
• D. All of the above

Correct answer: D

Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.

3. A mother reported to you that her 6-year-old child is suffering from diarrhea. Which of the following advice will you give to the mother?

• A. Breastfeeding should be continued day and night
• B. Formula milk should be stopped for 6 hours
• C. Breast milk can be given together with oral rehydration salts
• D. A and C

Correct answer: D

Rationale: When a child is suffering from diarrhea, it is essential to continue breastfeeding day and night to maintain hydration and provide necessary nutrients. Stopping formula milk for 6 hours (choice B) is not the recommended approach as it may lead to a lack of essential nutrients during this critical time. Giving breast milk together with oral rehydration salts (choice C) can help replenish lost fluids and electrolytes, making it a suitable recommendation. Therefore, advising the mother to follow both options A and C is the most appropriate approach to manage the child's condition effectively.

4. Which intervention is not appropriate for the hospitalized adolescent?

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

Correct answer: C

Rationale: Encouraging the adolescent to remain in the room throughout the hospitalization to ensure adequate rest periods is not appropriate. It is crucial for adolescents to have opportunities for physical activity and social interaction to promote their well-being during hospitalization. Allowing them to assist with procedures when possible can empower them and provide a sense of control. Encouraging discussions about their thoughts and feelings helps address their emotional needs. Facilitating peer visitation fosters social support, which is beneficial for their well-being. Therefore, choice C is the least appropriate as it restricts important aspects of the adolescent's development and coping mechanisms during hospitalization.

5. A 2-year-old client is admitted for an acute asthma episode. The hospital provides family-centered care. In explaining the program to the parents, the nurse would explain that the parents are:

• A. Required to implement all personal hygiene care for their child.
• B. Encouraged to be as involved with the child's care as they are comfortable being.
• C. Requested to administer all oral medications.
• D. Expected to be present at the child's bedside.

Correct answer: B

Rationale: Family-centered care involves encouraging parents to actively participate in their child's care based on their comfort level. This approach promotes collaboration between healthcare providers and families, enhancing the quality of care and ensuring the family's involvement in decision-making. Choice A is incorrect because parents are encouraged to participate, not required to implement all personal hygiene care. Choice C is incorrect as it implies a specific action rather than the broader concept of involvement. Choice D is incorrect as it focuses solely on physical presence rather than active participation in care.

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