Nursing Elites

1. What characteristic indicates that a mass on a newborn's head is a cephalohematoma?

• A. The mass appears on the second day after birth.
• B. The mass grows larger when the newborn cries.
• C. The head appears asymmetrical.
• D. The mass is located on only one side of the head.

Correct answer: A

Rationale: A cephalohematoma typically appears between the first and second days after birth, making choice A the correct answer. It results from blood vessel rupture between a cranial bone and the periosteal membrane. Choices B, C, and D are incorrect because the growth of the mass when the newborn cries, asymmetrical head appearance, or the mass being located on only one side of the head are not specific indicators of a cephalohematoma.

2. Why is a prolapsed umbilical cord dangerous?

• A. The cord may be wrapped around the baby's neck, causing strangulation.
• B. The cord might pull the placenta from the uterine wall during delivery.
• C. The baby's head may compress the cord, cutting off its supply of oxygen.
• D. The mother may die of hypoxia due to compromised placental blood flow.

Correct answer: C

Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.

3. What is the purpose of the pediatric assessment triangle?

• A. Detect immediate life threats through a quick hands-on assessment.
• B. Identify if the child has a medical condition or a traumatic injury.
• C. Determine if the child's problem is respiratory or circulatory in nature.
• D. Form a general impression of the child without touching them.

Correct answer: D

Rationale: The pediatric assessment triangle is used to form a rapid, hands-off general impression of the child's condition without directly touching them. This visual assessment helps in identifying children who require immediate attention and further evaluation.

4. When you attempt to assess a 22-year-old woman who has been sexually assaulted, she orders you not to touch her. Your MOST appropriate initial action should be to:

• A. obtain a signed refusal and return to service.
• B. transport the patient without performing an assessment.
• C. explain to the patient that she must be examined.
• D. ask a female EMT to attempt to assess the patient.

Correct answer: D

Rationale: In cases of sexual assault, it's important to respect the patient's wishes and provide a female EMT to attempt the assessment if the patient prefers.

5. During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should:

• A. gently push the protruding arm back into the vagina.
• B. encourage the mother to push and give her high-flow oxygen.
• C. insert your gloved fingers into the vagina and try to turn the baby.
• D. cover the arm with a sterile towel and transport immediately.

Correct answer: D

Rationale: When encountering a protruding limb during delivery, it is crucial to recognize this as an emergency situation. The correct action is to cover the limb with a sterile towel to prevent injury and transport the mother immediately to a medical facility. Attempting to push the limb back into the vagina or trying to manipulate the baby's position can be harmful and delay necessary medical intervention. Encouraging the mother to push and providing high-flow oxygen is not appropriate in this scenario as immediate transport is essential to ensure the safety of both the mother and the baby.

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