Nursing Elites

1. 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.

2. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:

• A. begin positive-pressure ventilations and reassess the child.
• B. lower the extremities and reassess the child.
• C. listen to the lungs with a stethoscope for abnormal breath sounds.
• D. insert a nasopharyngeal airway and increase the oxygen flow.

Correct answer: B

Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.

3. Serwaa, a 26-year-old mother has brought her daughter to the OPD with signs of lower respiratory tract infections. The following are the diagnoses that can be given to the daughter except:

• A. Pneumonia
• B. Asthma
• C. Bronchiolitis
• D. Coryza

Correct answer: D

Rationale: Coryza, also known as the common cold, primarily affects the upper respiratory tract and is not typically associated with lower respiratory tract infections. Pneumonia, asthma, and bronchiolitis are conditions that can manifest as lower respiratory tract infections.

4. Which of the following is NOT an infectious cause of diarrheal diseases?

• A. Allergy
• B. Bacterial
• C. Parasitic
• D. Viral

Correct answer: A

Rationale: Allergy is the correct answer as it is a non-infectious cause of diarrheal diseases. While bacterial, parasitic, and viral infections can lead to diarrhea by affecting the gastrointestinal tract, allergies are immune system reactions triggered by specific substances and are not caused by infectious agents. Bacterial, parasitic, and viral infections are known to cause infectious diarrhea, making choices B, C, and D incorrect.

5. Seizures in children MOST often result from:

• A. a life-threatening infection.
• B. an inflammatory process in the brain.
• C. an abrupt rise in body temperature.
• D. a temperature greater than 102°F.

Correct answer: C

Rationale: Seizures in children most often result from febrile seizures, which are triggered by an abrupt rise in body temperature. Febrile seizures are common in young children, especially between the ages of 6 months to 5 years, and are usually associated with viral infections that cause a sudden spike in body temperature. Choices A, B, and D are incorrect because while infections, inflammatory processes, and high temperatures can sometimes lead to seizures, the most common cause of seizures in children is an abrupt increase in body temperature, known as febrile seizures.

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