Nursing Elites

1. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. In addition to administering high-flow oxygen, treatment should include:

• A. treating for shock and uterine massage during transport.
• B. uterine massage and transport.
• C. placing her on her left side and transport.
• D. internal vaginal pads and treating for shock during transport.

Correct answer: A

Rationale: In this scenario, the mother is showing signs of postpartum hemorrhage with increased heart rate, diaphoresis, and mild vaginal bleeding. The correct approach involves treating for shock by addressing hypovolemia and providing uterine massage to help control bleeding. Administering high-flow oxygen is essential. Therefore, the most appropriate option is to treat for shock and perform uterine massage during transport to manage the postpartum hemorrhage effectively.

2. The nurse is preparing to administer erythromycin eye ointment to a newborn. The mother asks why this is necessary. What is the nurse's best response?

• A. It helps to prevent eye infections caused by bacteria in the birth canal.
• B. It protects the baby's eyes from bright lights in the delivery room.
• C. It prevents the development of jaundice.
• D. It helps the baby see more clearly after birth.

Correct answer: A

Rationale: Erythromycin eye ointment is administered to newborns to prevent eye infections caused by bacteria present in the birth canal. This ointment does not have a direct correlation with protecting the baby's eyes from bright lights, preventing jaundice, or improving the baby's vision clarity post-birth.

3. Which of the following is a sign of altered mental status in a small child?

• A. Fear of the EMT's presence.
• B. Recognition of the parents.
• C. Inattention to the EMT's presence.
• D. Consistent eye contact with the EMT.

Correct answer: C

Rationale: Inattention to the EMT's presence is a sign of altered mental status in a small child. When a child is not responsive or does not acknowledge the presence of the EMT, it could indicate a change in their mental status. This lack of attention or awareness may signify a neurological issue or other medical condition affecting the child's cognitive function.

4. Before drying off the newborn after birth, which assessment finding should the healthcare professional document to ensure an accurate gestational rating on the Ballard gestational assessment tool?

• A. Amount and area of vernix coverage
• B. Creases on the sole
• C. Size of the areola
• D. Body surface temperature

Correct answer: A

Rationale: To ensure an accurate gestational rating on the Ballard gestational assessment tool, healthcare professionals should document the amount and area of vernix coverage before drying the newborn. Drying the baby after birth could disturb the vernix, potentially affecting the gestational age assessment. Assessing and documenting the vernix coverage beforehand enables a more precise evaluation using the Ballard gestational assessment tool. Choices B, C, and D are incorrect as they are not directly related to gestational rating on the Ballard assessment tool.

5. Beta-adrenergic agonists such as Salbutamol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?

• A. Dilate the bronchioles
• B. Reduce secondary infections
• C. Decrease postnasal drip
• D. Reduce airway inflammation

Correct answer: A

Rationale: Beta-adrenergic agonists like Salbutamol are used to dilate the bronchioles in asthma patients. This action helps in relieving bronchospasms and improving airflow to the lungs, making breathing easier for the individual. While reducing inflammation is an essential part of asthma management, beta-adrenergic agonists primarily work by relaxing the smooth muscles around the airways, leading to bronchodilation. Choices B, C, and D are incorrect because beta-adrenergic agonists are not primarily used to reduce secondary infections, decrease postnasal drip, or directly reduce airway inflammation in asthma patients.

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