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. Following an apparent febrile seizure, a 4-year-old boy is alert and crying. His skin is hot and moist. Appropriate treatment for this child includes:

• A. allowing the parents to transport the child.
• B. offering oxygen and providing transport.
• C. rapidly cooling the child in cold water.
• D. keeping the child warm and providing transport.

Correct answer: B

Rationale: After a febrile seizure, the priority is to offer oxygen and provide transport to a medical facility. Oxygen may be necessary to ensure proper oxygenation, and medical evaluation is crucial to determine the cause of the seizure and prevent recurrence. Rapidly cooling the child in cold water is not recommended as it may lead to complications such as hypothermia. Keeping the child warm is also not indicated as the skin is already hot and moist. Therefore, offering oxygen and timely transportation to a healthcare facility is the most appropriate course of action. Allowing the parents to transport the child might delay necessary medical care, and keeping the child warm can exacerbate the existing heat. Rapidly cooling the child in cold water can lead to adverse effects, making it an inappropriate choice.

3. 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.

4. Which of the following is not a clinical type of diarrhea?

• A. Acute diarrhea
• B. Bloody diarrhea
• C. Persistent diarrhea
• D. Secretory diarrhea

Correct answer: B

Rationale: Bloody diarrhea is not typically classified as a clinical type of diarrhea. The clinical types of diarrhea commonly include acute, persistent, and secretory diarrhea, which are characterized by different mechanisms and durations. Bloody diarrhea usually indicates the presence of blood in the stool, which can be a sign of various underlying conditions but is not a specific clinical type of diarrhea.

5. A new mother is learning to breastfeed her newborn. Which position is recommended for a mother recovering from a cesarean section?

• A. Cradle hold
• B. Football hold
• C. Side-lying position
• D. Cross-cradle hold

Correct answer: B

Rationale: The football hold is recommended for mothers recovering from a cesarean section because it positions the baby higher up and away from the incision site, avoiding pressure on the abdomen. This hold also provides better support for the baby's head and neck, making it a more comfortable position for both the mother and the newborn.

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