Nursing Elites

1. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:

• A. placing the child supine and palpating the abdomen.
• B. separating the child from the parent to ensure a reliable examination.
• C. examining the child in the parent's arms.
• D. palpating the painful area of the abdomen first.

Correct answer: C

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.

2. Why is a prolapsed umbilical cord dangerous?

• A. The cord may be wrapped around the baby's neck, causing strangulation.
• B. The cord might pull the placenta from the uterine wall during delivery.
• C. The baby's head may compress the cord, cutting off its supply of oxygen.
• D. The mother may die of hypoxia due to compromised placental blood flow.

Correct answer: C

Rationale: A prolapsed umbilical cord is dangerous because the baby's head may compress the cord, cutting off its supply of oxygen. This compression can lead to oxygen deprivation, potentially causing significant harm to the baby. Immediate medical intervention is crucial in such cases to prevent adverse outcomes.

3. When 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. Goitrogens are substances that interfere with the normal function of the thyroid gland by inhibiting iodine uptake. Cabbage, along with other cruciferous vegetables like broccoli and cauliflower, contain compounds that can have this effect and should be consumed in moderation by individuals with hypothyroidism to prevent worsening of their condition.

4. How will a ventricular septal defect affect blood flow?

• A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
• B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
• C. No shunting occurs due to high pressure in the left ventricle.
• D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.

Correct answer: A

Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.

5. Management for a woman presenting with a prolapsed umbilical cord includes all of the following, EXCEPT:

• A. lifting the baby's head off the umbilical cord.
• B. placing the mother in a position that elevates her hips.
• C. ensuring that the cord stays moist during transport.
• D. relieving pressure off the cord by gently pulling on it.

Correct answer: D

Rationale: In cases of prolapsed umbilical cord, it is crucial to manage the situation promptly. The correct steps include lifting the baby's head off the umbilical cord to reduce pressure, placing the mother in a position that elevates her hips to relieve pressure on the cord, and ensuring that the cord stays moist. Pulling on the cord is not recommended as it can further compromise fetal circulation and should be avoided. Therefore, relieving pressure off the cord by gently pulling on it is not a recommended management approach in cases of prolapsed umbilical cord.

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