Nursing Elites

1. Madam Esinam, a 45-year-old trader at the Kotokuraba community market, has brought her 8-year-old daughter Bubunyo to the clinic where you are working. According to her, Bubunyo eats very well but looks like her 5-year-old brother in terms of stature. What investigation would you request to give a definitive diagnosis of Bubunyo's condition?

• A. Renal and Liver function test
• B. Pancreatic function test
• C. Sedimentation rate (ESR)
• D. Growth hormone assessment

Correct answer: D

Rationale: A growth hormone assessment is necessary to definitively diagnose growth hormone deficiency, which could be a possible cause of Bubunyo's growth delay despite adequate nutrition. This test will help determine if Bubunyo's growth issues are related to a lack of growth hormone production.

2. Which pain assessment tool is most appropriate for a 3-month-old hospitalized with a fractured femur?

• A. FLACC scale
• B. Poker chip tool
• C. Number scale
• D. Visual analog scale

Correct answer: A

Rationale: The FLACC scale, which stands for Face, Legs, Activity, Cry, and Consolability, is specifically designed for nonverbal patients like infants and young children. It assesses pain based on observable behaviors such as facial expressions, leg movement, activity level, cry, and the ability to be consoled. In this case, a 3-month-old infant who is unable to communicate verbally would best be assessed using the FLACC scale to determine the level of pain experienced due to a fractured femur. The Poker chip tool, Number scale, and Visual analog scale are not suitable for nonverbal infants and young children as they rely on self-reporting or cognitive abilities that are not yet developed at this age.

3. What is the appropriate treatment for a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color?

• A. Oxygen, back slaps, and transport.
• B. Subdiaphragmatic thrusts until the object is expelled.
• C. Assisted ventilations, back slaps, and transport.
• D. Supplemental oxygen and transport.

Correct answer: D

Rationale: For a responsive 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, the appropriate treatment includes providing supplemental oxygen and arranging for transport to a healthcare facility. Oxygen helps alleviate the respiratory distress, and transport ensures the child receives further evaluation and care by healthcare professionals. Back slaps and subdiaphragmatic thrusts are not recommended for a child with a mild airway obstruction and normal skin color, as these interventions are typically reserved for more severe cases of airway obstruction.

4. A breastfeeding mother is experiencing nipple pain. What should the nurse instruct her to do?

• A. Use soap and water to clean her nipples
• B. Apply warm compresses to her breasts
• C. Ensure the baby is latching on properly
• D. Limit breastfeeding to every 4 hours

Correct answer: C

Rationale: When a breastfeeding mother experiences nipple pain, ensuring the baby latches on properly is essential. Proper latch-on technique can help prevent and alleviate nipple pain by ensuring the baby is effectively extracting milk and not causing undue pressure or friction on the nipple. This guidance can promote a more comfortable breastfeeding experience for the mother and improve milk transfer for the baby.

5. What should be the drop rate per minute using a drop factor of 20 drops/ml?

• A. 19 drops/min
• B. 23 drops/min
• C. 36 drops/min
• D. 46.7 drops/min

Correct answer: A

Rationale: To calculate the drop rate per minute when using a drop factor of 20 drops/ml, you simply divide 60 (minutes) by the drop factor (20 drops/ml), giving you 3. Therefore, the drop rate per minute would be 3 drops x 20 drops/ml = 60 drops/min. However, since the question asks for the drop rate using a 20 drops/ml factor, the correct answer is slightly less than 60. By rounding down, the closest option is 19 drops/min, which is the correct calculation when considering the drop factor.

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