Nursing Elites

1. The healthcare provider is preparing to administer Rh immune globulin (RhoGAM) to a postpartum client. This medication is indicated for:

• A. Rh-negative individuals with Rh-positive infants
• B. Rh-positive individuals with Rh-negative infants
• C. All individuals regardless of Rh status
• D. Individuals with a history of Rh incompatibility

Correct answer: A

Rationale: Rh immune globulin (RhoGAM) is administered to Rh-negative individuals who have given birth to Rh-positive infants to prevent Rh sensitization. When an Rh-negative individual gives birth to an Rh-positive infant, there is a risk of the mother developing antibodies against the Rh-positive blood cells, which can lead to hemolytic disease of the newborn in subsequent pregnancies. Rh immune globulin is given to prevent this sensitization in Rh-negative individuals who deliver Rh-positive infants.

2. You are treating a 5-year-old child who has had severe diarrhea and vomiting for 3 days and is now showing signs of shock. Supplemental oxygen has been given, and you have elevated his lower extremities. En route to the hospital, you note that his work of breathing has increased. You should:

• A. begin positive-pressure ventilations and reassess the child.
• B. lower the extremities and reassess the child.
• C. listen to the lungs with a stethoscope for abnormal breath sounds.
• D. insert a nasopharyngeal airway and increase the oxygen flow.

Correct answer: B

Rationale: When the work of breathing increases after elevating the legs, it is important to lower the extremities. Elevating the lower extremities in a child with signs of shock can worsen the condition by reducing venous return to the heart. Lowering the extremities can help improve venous return and potentially alleviate the increased work of breathing.

3. A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. What is the appropriate compression to ventilation ratio for this child?

• A. 3:01
• B. 30:2
• C. 15:2
• D. 5:1

Correct answer: B

Rationale: The correct compression to ventilation ratio for a single rescuer performing CPR on a child is 30:2. This ratio ensures adequate circulation and oxygenation during CPR. 30 compressions help maintain blood flow, while 2 rescue breaths provide oxygenation. Choice A (3:01) is incorrect as it does not follow the standard CPR guidelines for children. Choice C (15:2) is incorrect as it is the ratio used for adult CPR. Choice D (5:1) is incorrect as it is not the recommended ratio for child CPR.

4. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 80 beats/min. What is the MOST appropriate initial management for this newborn?

• A. Assess the newborn's skin condition and color.
• B. Initiate positive-pressure ventilations.
• C. Start chest compressions and contact medical control.
• D. Provide blow-by oxygen with oxygen tubing.

Correct answer: B

Rationale: In a newborn with a heart rate below 100 beats/min, the most appropriate initial management is to initiate positive-pressure ventilations. This helps support the newborn's respiratory effort and oxygenation in the setting of a low heart rate, ensuring adequate oxygen supply to vital organs. Assessing the skin condition and color, starting chest compressions, or providing blow-by oxygen are not the priority in this scenario where respiratory support is crucial.

5. What is the main function of the uterus?

• A. Dilate and expel the baby from the cervix.
• B. House the fetus as it grows for 40 weeks.
• C. Provide a cushion and protect the fetus from infection.
• D. Provide oxygen and other nutrients to the fetus.

Correct answer: B

Rationale: The main function of the uterus is to house and nurture the growing fetus for approximately 40 weeks during pregnancy. It provides the necessary environment for the fetus to develop and grow until it is ready for birth. Choice A is incorrect as the cervix, not the uterus, dilates during labor to allow the baby to pass through. Choice C is incorrect as while the uterus does provide a protective environment, its primary function is not to act as a cushion. Choice D is incorrect as the placenta, not the uterus, is responsible for providing oxygen and nutrients to the fetus.

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