Nursing Elites

1. The healthcare provider is caring for a newborn who is 2 days old. Which finding should be reported to the healthcare provider?

• A. Yellowing of the skin
• B. Presence of a small amount of blood in the diaper
• C. Peeling skin on the hands and feet
• D. Intermittent episodes of sneezing

Correct answer: A

Rationale: Yellowing of the skin may indicate jaundice in a newborn, which can be a sign of an underlying health issue such as an elevated bilirubin level. It is essential to report this finding to the healthcare provider for further assessment and appropriate management to prevent complications.

2. Where is the most appropriate location to perform a procedure on a preschooler?

• A. Perform the procedure in the child's hospital bed.
• B. Perform the procedure in the treatment room.
• C. Allow the child to decide when the procedure will be performed.
• D. Ask the parents to help restrain the child so the procedure can be performed.

Correct answer: B

Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.

3. Which of the following is NOT an appropriate treatment for an 18-year-old woman with severe vaginal bleeding?

• A. Covering the vagina with a trauma dressing.
• B. Administering high concentrations of oxygen.
• C. Placing sterile dressings into the vagina.
• D. Keeping her warm with blankets.

Correct answer: C

Rationale: Placing sterile dressings into the vagina is not an appropriate treatment for severe vaginal bleeding. The correct approach involves applying pressure to the external vaginal area to control bleeding, covering the vagina with a trauma dressing to help with compression, administering high concentrations of oxygen to support oxygenation, and keeping the patient warm with blankets to prevent hypothermia. Placing sterile dressings into the vagina can introduce foreign material, increase the risk of infection, and obstruct proper wound management, making it an incorrect treatment option in this scenario.

4. Management for a woman presenting with a prolapsed umbilical cord includes all of the following, EXCEPT:

• A. lifting the baby's head off the umbilical cord.
• B. placing the mother in a position that elevates her hips.
• C. ensuring that the cord stays moist during transport.
• D. relieving pressure off the cord by gently pulling on it.

Correct answer: D

Rationale: In cases of prolapsed umbilical cord, it is crucial to manage the situation promptly. The correct steps include lifting the baby's head off the umbilical cord to reduce pressure, placing the mother in a position that elevates her hips to relieve pressure on the cord, and ensuring that the cord stays moist. Pulling on the cord is not recommended as it can further compromise fetal circulation and should be avoided. Therefore, relieving pressure off the cord by gently pulling on it is not a recommended management approach in cases of prolapsed umbilical cord.

5. When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the nurse would explain that squatting:

• A. Increases peripheral vascular resistance
• B. Decreases arterial blood flow away from the heart
• C. It's a common resting position when a child is tachycardic
• D. Increases the workload of the heart

Correct answer: A

Rationale: Squatting increases systemic vascular resistance, which leads to a reduction in the right-to-left shunting of blood in children with tetralogy of Fallot. This helps improve oxygenation by balancing the pulmonary and systemic blood flow. The squatting position decreases the pressure in the right ventricle and reduces the magnitude of the right-to-left shunt by increasing afterload, thereby improving oxygenation. Choices B, C, and D are incorrect because squatting does not decrease arterial blood flow away from the heart, is not related to being tachycardic, and does not increase the workload of the heart.

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