Nursing Elites

1. A postpartum client who delivered a healthy newborn is being assessed by a nurse. Which finding would indicate a complication during the early postpartum period?

• A. Moderate lochia rubra
• B. Bradycardia
• C. Elevated blood pressure
• D. Uterine contraction

Correct answer: C

Rationale: An elevated blood pressure in the postpartum period may indicate the onset of preeclampsia, a serious complication that requires immediate medical attention. Preeclampsia is characterized by high blood pressure, protein in the urine, and sometimes swelling in the hands and face. If left untreated, preeclampsia can lead to serious complications for both the mother and the baby. Therefore, it is crucial for healthcare providers to closely monitor blood pressure levels in postpartum clients to promptly address any signs of preeclampsia. Choices A, B, and D are not indicative of a complication during the early postpartum period. Moderate lochia rubra is a normal finding as it indicates the normal discharge of blood and tissue from the uterus after childbirth. Bradycardia, a slow heart rate, is not typically a concern in the absence of other symptoms or signs of distress. Uterine contractions are essential for involution and are expected in the postpartum period.

2. In educating the parents of a child diagnosed with hypothyroidism, the nurse mentions that the child should avoid goitrogens. Which of the following will the nurse mention as an example?

• A. Orange
• B. Tomatoes
• C. Cabbage
• D. Grapes

Correct answer: C

Rationale: Cabbage is an example of a goitrogen that should be avoided in children with hypothyroidism. Goitrogens are substances that can interfere with thyroid function by inhibiting iodine uptake, potentially worsening the condition. Cabbage, along with other cruciferous vegetables like broccoli and cauliflower, contains compounds that can affect thyroid hormone production. Oranges, tomatoes, and grapes are not classified as goitrogens. Therefore, it is important for parents to be aware of foods like cabbage and to limit their child's intake to help manage their hypothyroidism effectively.

3. Physical abuse of a 4-year-old child should be suspected if you observe:

• A. purple and yellow bruises on the thighs.
• B. bruises on the anterior tibial area.
• C. the child clinging to his or her parent.
• D. curious siblings watching you.

Correct answer: A

Rationale: Purple and yellow bruises on protected areas like the thighs are concerning as they indicate bruises in various stages of healing, which is a red flag for physical abuse. Bruises on the anterior tibial area or a child clinging to a parent are not specific signs of physical abuse. Siblings watching you is unrelated to the suspicion of physical abuse in this scenario.

4. Which of the following statements regarding pediatric anatomy is correct?

• A. The child's trachea is more rigid and less prone to collapse.
• B. The occiput is proportionately larger when compared to an adult.
• C. Airway obstruction is common in children due to their large uvula.
• D. Relative to the overall size of the airway, a child's epiglottis is smaller.

Correct answer: B

Rationale: The occiput, the back part of the head, is proportionately larger in children compared to adults, which can have implications for airway management techniques. This anatomical difference is important to consider when providing care to pediatric patients, especially during airway interventions.

5. Which of the following findings is abnormal?

• A. Rapid, irregular breathing in a newly born infant
• B. Heart rate of 80 beats/min in a 3-month-old infant
• C. Respiratory rate of 26 breaths/min in a 2-year-old child
• D. Systolic BP of 100 mm Hg in a 10-year-old child

Correct answer: B

Rationale: A heart rate of 80 beats per minute in a 3-month-old infant is abnormally low for that age group and could indicate underlying health issues. The normal heart rate for a 3-month-old infant is typically higher, around 100-150 beats per minute. Therefore, this finding stands out as abnormal and warrants further evaluation. Choice A is not necessarily abnormal in a newly born infant as irregular breathing patterns can be common during the neonatal period. Choice C falls within the normal respiratory rate range for a 2-year-old child, which is around 20-30 breaths per minute. Choice D reflects a systolic blood pressure value within the normal range for a 10-year-old child, which is typically around 90-110 mm Hg.

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