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, it is important to offer oxygen and provide transport to a medical facility for further evaluation and management of the underlying cause. Oxygen may be needed in case of hypoxemia resulting from the seizure. 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 advisable as the priority is to prevent hyperthermia and provide necessary medical intervention by healthcare providers.

2. The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby's head is so pointed and puffy-looking. What is the best response by the nurse?

• A. His head is molded from fitting through the birth canal. It will become more round.
• B. We refer to that as 'cone head,' which is a temporary condition that goes away.
• C. It might mean that your baby sustained brain damage during birth, and could have delays.
• D. I think he looks just like you. Your head is much the same shape as your baby's.

Correct answer: A

Rationale: The corrected response 'His head is molded from fitting through the birth canal. It will become more round.' is the best answer as it explains the physiological reason for the baby's appearance after birth. It reassures the father that the pointed and puffy-looking head is a normal part of the birthing process and will resolve on its own. Choice B is incorrect because while 'cone head' is a term used colloquially, it does not provide a detailed explanation. Choice C is incorrect and should be avoided as it introduces unnecessary worry by suggesting brain damage. Choice D is not an appropriate response as it doesn't address the father's concern or provide accurate information about newborn physiology.

3. The healthcare provider is caring for a newborn who is 2 days old. Which finding should be reported to the healthcare provider?

• A. Yellowing of the skin
• B. Presence of a small amount of blood in the diaper
• C. Peeling skin on the hands and feet
• D. Intermittent episodes of sneezing

Correct answer: A

Rationale: Yellowing of the skin may indicate jaundice in a newborn, which can be a sign of an underlying health issue such as an elevated bilirubin level. It is essential to report this finding to the healthcare provider for further assessment and appropriate management to prevent complications.

4. A 3-year-old child has a sudden onset of respiratory distress. The mother denies any recent illnesses or fever. You should suspect:

• A. croup.
• B. foreign body airway obstruction.
• C. lower respiratory infection.
• D. epiglottitis.

Correct answer: B

Rationale: In a 3-year-old child with a sudden onset of respiratory distress and no recent illnesses or fever, the likely cause is a foreign body airway obstruction. Foreign body obstruction can lead to sudden respiratory distress without other preceding symptoms. It is crucial to consider this possibility and act promptly to clear the airway in such cases to prevent serious complications.

5. What is the proper depth of chest compressions for a 9-month-old infant?

• A. 1/3 the diameter of the chest or about 1 1/2 inches.
• B. 1/4 the diameter of the chest or about 1 inch.
• C. 1/2 the diameter of the chest or about 2 inches.
• D. 1/3 the diameter of the chest or about 3/4 inch.

Correct answer: A

Rationale: When performing chest compressions on a 9-month-old infant, the proper depth is 1/3 the diameter of the chest, which equates to approximately 1 1/2 inches. This depth is crucial for effective cardiopulmonary resuscitation (CPR) in infants. Choice B, which suggests 1/4 the diameter of the chest or about 1 inch, is incorrect as it does not provide the recommended depth for infants. Choice C, stating 1/2 the diameter of the chest or about 2 inches, is too deep and may cause harm to the infant. Choice D, mentioning 1/3 the diameter of the chest or about 3/4 inch, is also incorrect as it underestimates the required depth for effective chest compressions on a 9-month-old infant.

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