Nursing Elites

1. What assessment finding places a newborn at risk for developing physiologic jaundice?

• A. Cephalohematoma
• B. Mongolian spots
• C. Telangiectatic nevi
• D. Molding

Correct answer: A

Rationale: The correct answer is A, Cephalohematoma. Physiologic jaundice in newborns can occur due to the breakdown of excess red blood cells. A cephalohematoma, a collection of blood caused by ruptured blood vessels between a cranial bone's surface and periosteal membrane, can lead to increased red blood cell breakdown. This increased breakdown can contribute to the development of physiologic jaundice in newborns. Choices B, Mongolian spots, and C, Telangiectatic nevi, are both benign skin conditions and are not directly associated with increased red blood cell breakdown. Choice D, Molding, refers to the shaping of the fetal head during passage through the birth canal and is not related to the development of physiologic jaundice.

2. Which statement best describes direct contact as a mode of pathogen transmission?

• A. Transmission through large aerosols produced by sneezing or coughing
• B. Transfer of an infectious agent by suspended air particles from a reservoir to a host
• C. Transmission of infectious agents carried by dust
• D. Transmission through skin-to-skin contact or body fluids

Correct answer: D

Rationale: Direct contact transmission occurs when pathogens are spread through skin-to-skin contact or body fluids. This mode of transmission includes activities like touching, kissing, or sexual contact where infectious agents can pass directly from one person to another. It does not involve large aerosols, suspended air particles, or dust as carriers of the pathogen.

3. A group of nursing students is discussing trends that influence pediatric health care today. The students' discussion focuses on which trends?

• A. Family-centered care
• B. Evidenced-based practice
• C. Nursing traditions
• D. A and B

Correct answer: D

Rationale: In pediatric health care, family-centered care and evidenced-based practice are crucial trends that impact care delivery. Family-centered care involves involving the family in decision-making and care planning, recognizing their role in the child's well-being. Evidenced-based practice ensures nursing interventions are based on the best available evidence to provide high-quality care to pediatric patients. Nursing traditions, though important, may not encompass the latest advancements in pediatric care. Therefore, choices A and B are correct as they represent current influential trends in pediatric health care.

4. 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.

5. 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.

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