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 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.

3. Madam Esinam, a 45-year-old trader at the Kotokuraba community market, has brought her 8-year-old daughter Bubunyo to the clinic where you are working. According to her, Bubunyo eats very well but looks like her 5-year-old brother in terms of stature. What investigation would you request to give a definitive diagnosis of Bubunyo's condition?

• A. Renal and Liver function test
• B. Pancreatic function test
• C. Sedimentation rate (ESR)
• D. Growth hormone assessment

Correct answer: D

Rationale: A growth hormone assessment is necessary to definitively diagnose growth hormone deficiency, which could be a possible cause of Bubunyo's growth delay despite adequate nutrition. This test will help determine if Bubunyo's growth issues are related to a lack of growth hormone production.

4. What action should you take if a newborn's heart rate is 50 beats/min?

• A. Begin chest compressions.
• B. Reassess in 30 seconds.
• C. Administer blow-by oxygen.
• D. Start positive-pressure ventilations.

Correct answer: D

Rationale: If a newborn's heart rate is below 60 beats per minute, the appropriate action is to start positive-pressure ventilations. Ventilations help deliver oxygen to the newborn's body and support respiratory function, which is critical in cases of bradycardia. Chest compressions are not recommended until the heart rate is below 60 despite adequate ventilation. Reassessment is essential but not the immediate action required in this scenario. Administering blow-by oxygen alone may not effectively address the underlying cause of bradycardia, making positive-pressure ventilations the priority intervention in this case.

5. Which of the following signs is MOST indicative of inadequate breathing in an infant?

• A. Sunken fontanelles
• B. Heart rate of 130 beats/min
• C. Expiratory grunting
• D. Abdominal breathing

Correct answer: C

Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.

Similar Questions