Nursing Elites

1. A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform your assessment and administer supplemental oxygen. En route to the hospital, you should be MOST alert for:

• A. hypotension.
• B. combativeness.
• C. convulsions.
• D. respiratory distress.

Correct answer: C

Rationale: In a 7-year-old child with altered mental status, high fever, and a generalized rash, the most critical concern is the potential for convulsions. These symptoms could indicate a serious underlying condition, such as a febrile seizure or another type of seizure activity. Monitoring for convulsions is crucial during transport to ensure prompt intervention if they occur, as seizures can lead to additional complications and require immediate management.

2. 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.

3. After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a shock advised message. After delivering the shock, you should:

• A. assess for a carotid pulse.
• B. open the airway and ventilate.
• C. immediately perform CPR.
• D. reanalyze the cardiac rhythm.

Correct answer: C

Rationale: After delivering a shock, it is crucial to immediately resume CPR. CPR helps circulate oxygenated blood to vital organs until the AED prompts you to stop for further rhythm analysis. This continuous cycle of CPR and defibrillation maximizes the chances of restoring a normal cardiac rhythm and improving the child's chances of survival. Assessing for a carotid pulse is not necessary after a shock as pulse checks are often unreliable during resuscitation. Opening the airway and ventilating is not the immediate step after delivering a shock as CPR takes precedence. Reanalyzing the cardiac rhythm should be done only when prompted by the AED after a set period of CPR.

4. What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?

• A. Insert the needle and aspirate before injecting
• B. Inject insulin into the extremity to be exercised to improve absorption
• C. The muscles in the abdomen and thigh are the easiest for self-administration
• D. Clean the injection site with soap and water and avoid alcohol

Correct answer: C

Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.

5. What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?

• A. Oxygen, back slaps, and transport.
• B. Subdiaphragmatic thrusts until the object is expelled.
• C. Assisted ventilations, back slaps, and transport.
• D. Supplemental oxygen and transport.

Correct answer: D

Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.

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