Nursing Elites

1. 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.

2. 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.

3. A 3-year-old child has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, a final diagnosis of lower respiratory infection was made. Which of the following signs will confirm the diagnosis?

• A. Cough
• B. Fever
• C. Inability to lie supine
• D. Inability to eat

Correct answer: C

Rationale: Inability to lie supine is a characteristic sign of lower respiratory infection. This positioning preference is often seen in patients with lower respiratory infections due to discomfort or difficulty breathing when lying flat on their back. While cough and fever are common symptoms associated with respiratory infections, they are not specific to lower respiratory infections. Inability to eat may indicate general illness or discomfort but is not a specific indicator of lower respiratory infection.

4. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?

• A. begin ventilations with a bag-mask device.
• B. gently flick the soles of their feet for up to 60 seconds.
• C. immediately suction their mouth and nose.
• D. start CPR if the heart rate is less than 80 beats/min.

Correct answer: A

Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.

5. Based on the complaints provided by Madam KK, is the child exhibiting danger signs?

• A. Yes
• B. No
• C. I don't know
• D. Yes

Correct answer: A

Rationale: Yes, the child is displaying danger signs with symptoms such as fever and rapid breathing, indicating a potential serious health issue that requires immediate attention. The correct answer is 'Yes' because the symptoms described in Madam KK's complaints align with danger signs that suggest a severe health problem. Choices B and C are incorrect because the symptoms mentioned clearly indicate the presence of danger signs. Choice D is a duplicate of choice A and does not provide a valid alternative.

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