Nursing Elites

1. When preventing cardiac arrest in infants and small children, the primary focus should be on:

• A. Providing immediate transport.
• B. Ensuring adequate ventilation.
• C. Keeping the child warm.
• D. Avoiding upsetting the child.

Correct answer: B

Rationale: The correct approach to prevent cardiac arrest in infants and small children is to ensure adequate ventilation. In these cases, maintaining proper oxygenation and ventilation is crucial for sustaining life. Providing immediate transport, keeping the child warm, or avoiding upsetting the child are important considerations but ensuring adequate ventilation takes precedence in preventing cardiac arrest and supporting the child's vital functions.

2. The healthcare provider is assessing a newborn who is 2 hours old. Which finding requires immediate intervention?

• A. Acrocyanosis
• B. Respiratory rate of 60 breaths per minute
• C. Grunting with nasal flaring
• D. Heart rate of 140 beats per minute

Correct answer: C

Rationale: Grunting with nasal flaring is a concerning sign of respiratory distress in a newborn that can indicate inadequate oxygenation. This finding requires immediate intervention to ensure the newborn's respiratory status is stabilized and to prevent further complications. Prompt assessment and appropriate intervention are crucial in such cases to prevent respiratory compromise and potential deterioration. Acrocyanosis, which is bluish discoloration of the extremities, is a common finding in newborns and usually resolves on its own. A respiratory rate of 60 breaths per minute and a heart rate of 140 beats per minute are within normal ranges for a newborn and do not indicate immediate intervention is needed.

3. Which of the following is an abnormal finding when assessing the abdomen of a newborn?

• A. The umbilical cord has two arteries and one vein.
• B. The presence of green vomit.
• C. The liver is palpable 1 to 2 cm below the costal margin.
• D. The abdomen is soft and nondistended.

Correct answer: B

Rationale: The correct answer is B. The presence of green vomit in a newborn is an abnormal finding and indicates a possible intestinal obstruction. This finding requires immediate attention and further investigation. Choices A, C, and D are normal findings in a newborn's abdomen assessment. A newborn typically has an umbilical cord with two arteries and one vein, a liver that may be palpable 1 to 2 cm below the costal margin due to its normal size in a neonate, and a soft, nondistended abdomen as expected in healthy newborns.

4. A breastfeeding mother reports to the nurse that her newborn nurses every hour and never seems satisfied. Which advice should the nurse provide?

• A. Supplement breastfeeding with formula after each nursing session.
• B. Allow the newborn to nurse on each breast for at least 20 minutes.
• C. Reduce the number of nursing sessions to every 2-3 hours.
• D. Ensure the newborn has a proper latch and is effectively nursing.

Correct answer: D

Rationale: The nurse should ensure that the newborn has a proper latch and is effectively nursing. Sometimes, newborns nurse frequently for comfort even when they are effectively latched. It is essential to address the latch first before considering other interventions. Supplementing with formula (Choice A) may decrease the mother's milk supply. Allowing the newborn to nurse for a set time (Choice B) may not address the underlying latch issue. Reducing nursing sessions (Choice C) may lead to decreased milk production and does not address the latch problem.

5. A postpartum client is being discharged and asks the nurse when she should expect her menstrual period to return if she is not breastfeeding. The nurse's best response is:

• A. In about 6 to 8 weeks
• B. In about 3 to 4 months
• C. In about 6 months
• D. In about 1 year

Correct answer: A

Rationale: For non-breastfeeding mothers, the return of menstrual periods typically occurs around 6 to 8 weeks postpartum. This timeframe may vary among individuals, but generally, hormonal changes after childbirth lead to the resumption of menstrual cycles within this period.

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