Nursing Elites

1. What is the reason for Asthma in 4-year-old Mabele, as Mrs. Joyce Thomson inquires? How would you explain it?

• A. Asthma occurs due to inflammation of the respiratory tract triggered by infections.
• B. An asthmatic attack can occur when the child is exposed to certain allergens, triggering an allergic reaction in the bronchioles that causes bronchial constriction.
• C. An asthmatic attack is a response to the release of inflammatory mediators to epithelial cells, affecting the autonomic neural control of the airway.
• D. Asthma is not an inborn problem; it involves abnormal growth of the bronchial tree causing restriction.

Correct answer: B

Rationale: Asthma in children like Mabele can be triggered by exposure to allergens, leading to an allergic reaction in the bronchioles. This reaction causes constriction of the bronchial tree, resulting in an asthmatic attack. It is essential for caregivers to identify and minimize exposure to these triggers to manage and prevent asthma episodes effectively.

2. When teaching a new mother how to perform perineal care, which instruction should be included?

• A. Use a front-to-back motion when cleaning the perineal area
• B. Use a peri-bottle filled with warm water after each voiding
• C. Avoid using any cleansing solution on the perineal area
• D. Apply powder to the perineal area to keep it dry

Correct answer: B

Rationale: Using a peri-bottle filled with warm water after each voiding is essential for proper perineal care as it helps cleanse the area without causing irritation and promotes healing. It is important to avoid using a back-to-front motion to prevent introducing bacteria into the urethra, and using powder may increase the risk of infection. Cleansing solutions specifically formulated for perineal care may be recommended but should be used under healthcare provider guidance.

3. A new mother expresses concern about her baby's frequent hiccups. What should the nurse explain about newborn hiccups?

• A. Hiccups are a sign of respiratory distress in newborns.
• B. Hiccups indicate the baby is overeating.
• C. Hiccups are common and usually harmless in newborns.
• D. Hiccups are caused by a lack of burping.

Correct answer: C

Rationale: Newborn hiccups are common and usually harmless. They are typically caused by the baby's immature diaphragm and tend to resolve on their own. It is essential for parents to understand that hiccups in newborns are a normal phenomenon and do not necessarily indicate any underlying health issue. Choice A is incorrect because hiccups are not a sign of respiratory distress in newborns. Choice B is incorrect as hiccups do not indicate the baby is overeating. Choice D is also incorrect as hiccups are not solely caused by a lack of burping.

4. A 3-year-old female has had severe diarrhea and vomiting for 4 days. She is now unresponsive with rapid, shallow respirations and thready radial pulses. Her heart rate is 160 beats/min, and her oxygen saturation is 88%. You should:

• A. Ventilate her with a bag-valve mask.
• B. Start chest compressions.
• C. Administer high-flow oxygen via a non-rebreathing mask.
• D. Place her in the recovery position.

Correct answer: A

Rationale: In a pediatric patient presenting with unresponsiveness, rapid, shallow respirations, thready pulses, high heart rate, and low oxygen saturation, the priority is to ensure adequate oxygenation. Ventilating the child with a bag-valve mask is crucial in this scenario to support her breathing and improve oxygenation, as indicated by her low oxygen saturation and respiratory distress. Starting chest compressions is not indicated as the child has a pulse. Administering high-flow oxygen via a non-rebreathing mask may not be as effective as providing positive pressure ventilation with a bag-valve mask in this situation. Placing her in the recovery position is not appropriate when the child is unresponsive and in respiratory distress.

5. A child was brought to the emergency department with complaints of nausea, vomiting, and fruity-scented breath. The resident on duty diagnosed the child with diabetic ketoacidosis. Which of the following should the nurse expect to administer?

• A. Potassium chloride IV infusion.
• B. Dextrose 5% IV infusion.
• C. Ringer's Lactate.
• D. Normal saline IV infusion

Correct answer: D

Rationale: In diabetic ketoacidosis (DKA), there is a state of dehydration and electrolyte imbalance. Normal saline is the initial fluid of choice to help restore intravascular volume and improve electrolyte balance. It also helps to correct acidosis. Potassium chloride IV infusion is commonly added to the treatment regimen once kidney function is confirmed to prevent hypokalemia. Dextrose 5% IV infusion is not the first-line treatment for DKA as it can worsen hyperglycemia. Ringer's Lactate is not typically used as the initial fluid for managing DKA as it contains potassium and could worsen hyperkalemia.

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