Nursing Elites

1. What is the aim of Integrated Management of neonatal and Childhood Illnesses?

• A. Improved case management
• B. Improved family and community practices
• C. None of the above
• D. A & B

Correct answer: D

Rationale: The aim of the Integrated Management of neonatal and Childhood Illnesses is to enhance both case management and family and community practices. By improving case management, healthcare providers can ensure appropriate treatment and care, leading to better outcomes for neonates and children. Enhancing family and community practices can contribute to the prevention, early detection, and overall well-being of children. Choice A is incorrect as the aim is not solely focused on improved case management. Choice B is incorrect as the aim goes beyond just improving family and community practices. Choice C is incorrect as the correct aim involves both improved case management and family/community practices, making choice D the most comprehensive and accurate answer.

2. Use the scenario to answer questions 13-18. A patient has come to the OPD with complaints of anaesthesia and paresthesia of the lower limbs. After laboratory investigations, the doctor has diagnosed the patient with Diabetes Mellitus but failed to specify whether it is type 1 or type 2. Onset of Type 1 diabetes is characterized by:

• A. Occurs after pubertal onset in the majority of cases
• B. Occurs when parents are poor
• C. Occurs at an early age
• D. Occurs after childbirth

Correct answer: A

Rationale: Type 1 diabetes typically occurs after pubertal onset. This form of diabetes is most commonly diagnosed in individuals under the age of 30, with a peak incidence in the mid-teens to early 20s. Puberty is a period of hormonal changes and growth, which can trigger the onset of type 1 diabetes due to the stress it places on the body's insulin-producing cells.

3. 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.

4. The healthcare provider is providing postpartum care to a client who had a vaginal delivery. Which finding would require further assessment?

• A. Perineal swelling
• B. Moderate lochia serosa
• C. Headache unrelieved by analgesics
• D. Breast engorgement

Correct answer: C

Rationale: A headache unrelieved by analgesics can be a sign of a serious condition such as preeclampsia, which is a life-threatening condition characterized by high blood pressure and often protein in the urine. Prompt assessment and intervention are crucial to prevent complications for both the mother and baby.

5. You are dispatched to a residence for a 5-year-old child who is not breathing. Upon arrival, you find the child supine on the floor, cyanotic, and unresponsive. You should first:

• A. begin chest compressions.
• B. open the airway and give two rescue breaths.
• C. apply an AED and analyze the rhythm.
• D. ask the parent for the child's medical history.

Correct answer: B

Rationale: When encountering an unresponsive and not breathing child, the initial step is to open the airway and provide two rescue breaths. This action helps to deliver oxygen to the child's lungs and body, which is crucial in attempting to restore breathing and circulation. Chest compressions are not initiated first in pediatric cases unless the child has no signs of circulation after delivering rescue breaths. Applying an AED and analyzing the rhythm is not the initial step in a pediatric cardiac arrest scenario, as the primary focus should be on providing oxygenation. Asking the parent for the child's medical history is not the immediate priority when the child is unresponsive and not breathing, as interventions to support breathing and circulation should be the primary concern.

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