Nursing Elites

1. A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?

• A. Liver
• B. Kidney
• C. Pancreas
• D. Spleen

Correct answer: D

Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.

2. When discussing heart conditions, a healthcare provider explains a condition in which the lungs retain extra fluid due to left ventricular impairment. What is this condition?

• A. Whooping cough
• B. Pneumonia
• C. Asthma
• D. Pulmonary edema

Correct answer: D

Rationale: Pulmonary edema is the correct answer. It is a condition characterized by the retention of extra fluid in the lungs, often due to left ventricular impairment. This fluid buildup can lead to symptoms such as shortness of breath, coughing, and difficulty breathing. Whooping cough (Choice A), pneumonia (Choice B), and asthma (Choice C) are not conditions related to the retention of fluid in the lungs due to left ventricular impairment. Whooping cough is a bacterial respiratory infection, pneumonia is an infection that inflames the air sacs in one or both lungs, and asthma is a chronic respiratory condition characterized by airway inflammation and constriction.

3. The provider is educating the parents of a newborn about circumcision care. Which of the following instructions should be included?

• A. Cleanse the penis with each diaper change using alcohol wipes.
• B. Avoid using petroleum jelly on the circumcision site.
• C. Report any yellowish exudate around the head of the penis.
• D. Use warm water to clean the penis gently during diaper changes.

Correct answer: D

Rationale: The correct instruction for circumcision care is to use warm water to gently clean the penis during diaper changes. Alcohol wipes should be avoided as they can cause irritation. Yellowish exudate around the head of the penis is a normal part of the healing process and does not require reporting unless accompanied by other concerning symptoms. Avoiding petroleum jelly on the circumcision site is important to prevent trapping moisture and bacteria, which can lead to infection.

4. When assessing a 30-year-old female in labor, what should the EMT do?

• A. Ask the mother when she is expecting to deliver.
• B. Avoid questioning the patient about her medical history.
• C. Determine the stage of her labor by examining her.
• D. Recall that delivery is imminent if she is crowning.

Correct answer: D

Rationale: During the assessment of a 30-year-old female in labor, the EMT should be aware that delivery is imminent if she is crowning. Crowning indicates that the baby's head is visible at the vaginal opening, signaling that the birth is progressing rapidly and the baby will soon be delivered. This is a critical moment that requires preparedness for the birth process and ensuring a safe delivery environment. Choice A is incorrect because asking the mother when she is expecting to deliver is not relevant when the baby's head is visible at the vaginal opening. Choice B is incorrect as obtaining the patient's medical history is essential for providing appropriate care. Choice C is incorrect because determining the stage of labor by examining the patient is important but recognizing crowning indicates that delivery is imminent and requires immediate action.

5. Which of the following is MOST likely to occur in conjunction with a breech presentation?

• A. Vertex presentation
• B. Maternal hypertension
• C. Prolapsed umbilical cord
• D. Premature rupture of the amniotic sac

Correct answer: C

Rationale: In a breech presentation, where the baby's buttocks or feet present first, there is an increased risk of the umbilical cord slipping down alongside or below the presenting part, leading to a prolapsed umbilical cord. This is a serious complication that can compromise fetal blood flow and oxygenation, necessitating prompt intervention to prevent adverse outcomes. Choices A, B, and D are less likely to occur in conjunction with a breech presentation. Vertex presentation is the normal head-first presentation, maternal hypertension is a separate condition that may not be directly related to fetal presentation, and premature rupture of the amniotic sac can happen independently of the baby's presentation.

Similar Questions