Nursing Elites

1. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:

• A. allowing the parents to transport the child.
• B. offering oxygen and providing transport.
• C. rapidly cooling the child in cold water.
• D. keeping the child warm and providing transport.

Correct answer: B

Rationale: After a febrile seizure, the priority is to offer oxygen and provide transport to a medical facility. Oxygen may be necessary to ensure proper oxygenation, and medical evaluation is crucial to determine the cause of the seizure and prevent recurrence. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not indicated as the skin is already hot and moist. Therefore, offering oxygen and timely transportation to a healthcare facility is the most appropriate course of action. Allowing the parents to transport the child might delay necessary medical care, and keeping the child warm can exacerbate the existing heat. Rapidly cooling the child in cold water can lead to adverse effects, making it an inappropriate choice.

2. Which of the following signs or symptoms is more common in children than adults following an isolated head injury?

• A. Changes in pupillary reaction
• B. Tachycardia and diaphoresis
• C. Nausea and vomiting
• D. Altered mental status

Correct answer: C

Rationale: Nausea and vomiting are more common in children than adults following an isolated head injury. Children often present with gastrointestinal symptoms like nausea and vomiting after a head injury due to differences in physiological responses compared to adults.

3. A new mother is learning to breastfeed her newborn. Which position is recommended for a mother recovering from a cesarean section?

• A. Cradle hold
• B. Football hold
• C. Side-lying position
• D. Cross-cradle hold

Correct answer: B

Rationale: The football hold is recommended for mothers recovering from a cesarean section because it positions the baby higher up and away from the incision site, avoiding pressure on the abdomen. This hold also provides better support for the baby's head and neck, making it a more comfortable position for both the mother and the newborn.

4. When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, which of the following questions would be MOST appropriate to ask?

• A. When did you first notice the symptoms?
• B. Do you have a history of high blood pressure?
• C. What medications do you take and why?
• D. Have you previously had a heart attack?

Correct answer: A

Rationale: The most appropriate question to ask when assessing a geriatric patient who may have experienced an acute ischemic stroke is when the symptoms were first noticed. This information is crucial for determining the time window for potential treatments like thrombolytic therapy, as prompt intervention is necessary for stroke management. Option B is not as relevant in the acute assessment of stroke, though important for overall health history. Option C is important but may not be as time-sensitive as determining symptom onset. Option D focuses on a different cardiac event, not directly related to the current concern of a possible stroke.

5. When assisting ventilations in a 4-year-old child with a bag-valve mask, what should the EMT do?

• A. Deliver each breath over 2 to 3 seconds.
• B. Ensure the appropriate mask size is used.
• C. Block the pop-off valve if needed to achieve adequate chest rise.
• D. Reassess the pulse rate after 60 seconds.

Correct answer: C

Rationale: When assisting ventilations in a 4-year-old child with a bag-valve mask, the EMT should block the pop-off valve if needed to achieve adequate chest rise. This action helps ensure effective ventilation and adequate oxygenation in the child. Blocking the pop-off valve allows for better control over the volume of air delivered and can help maintain positive pressure in the airway, assisting in improving oxygenation and ventilation in the child. Choices A, B, and D are incorrect because delivering each breath over 2 to 3 seconds is a general guideline but may need adjustment based on patient response, ensuring the appropriate mask size is important but not the primary concern in this scenario, and reassessing the pulse rate is not directly related to the ventilation technique being discussed.

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