Nursing Elites

1. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn?

• A. begin positive pressure ventilations
• B. provide blow-by oxygen with oxygen tubing
• C. assess the newborn's skin condition and color
• D. start chest compressions and contact medical control

Correct answer: A

Rationale: A heart rate below 100 beats/min in a newborn indicates the need for positive pressure ventilation to improve oxygenation. Providing positive pressure ventilations helps in assisting the newborn's breathing efforts to ensure adequate oxygenation. Choice B, providing blow-by oxygen, may not be sufficient to address the underlying issue of inadequate breathing. Choice C, assessing the newborn's skin condition and color, is important but not the most immediate action needed for a heart rate below 100 beats/min. Choice D, starting chest compressions, is not indicated as the infant is breathing spontaneously and has a heart rate, albeit lower than normal, which does not warrant chest compressions.

2. A mother confides to the nurse that she is thinking of divorce. Which suggestion by the nurse would help minimize the effects on the child?

• A. Tell the child together using appropriate terms.
• B. Reassure the child that no one loves him more than his parents.
• C. Engage in special activities with the child to compensate for the divorce.
• D. Keep your feelings to yourself and maintain a positive facade with the child.

Correct answer: A

Rationale: In situations of divorce, it is crucial for both parents to inform the child together using age-appropriate language. This approach helps maintain consistency and clarity for the child, reducing confusion and anxiety. Choice B is incorrect because reassurance should not be solely focused on love but on explaining the situation appropriately. Choice C may inadvertently send the message that the divorce is the child's fault or requires compensation. Choice D is incorrect as children benefit from understanding and processing emotions in a healthy manner, rather than having them kept hidden.

3. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

4. A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?

• A. Cannot stand on one foot
• B. Builds a tower of 7 blocks
• C. Uses echolalia when speaking
• D. Colors outside the lines of a picture

Correct answer: C

Rationale: The correct answer is C because using echolalia (repeating words or phrases) is not typical for a 2-year-old and may indicate the need for further evaluation. Choices A, B, and D are within the expected developmental skills for a 2-year-old. While a 2-year-old may not be able to stand on one foot for an extended period, it is not a concerning developmental milestone at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both age-appropriate activities that demonstrate fine motor skills and creativity, respectively. However, echolalia at this age could be a sign of an underlying communication or developmental issue that warrants further assessment and monitoring.

5. After completing an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?

• A. Before starting school
• B. Within the next few months
• C. When the first deciduous teeth are lost
• D. At the next dental visit of a family member

Correct answer: B

Rationale: It is recommended that a child should visit the dentist within the next few months after turning two years old. This allows for early dental check-ups to monitor oral health, detect any issues early on, and establish a good oral hygiene routine. Choice A ('Before starting school') is not as specific and may delay the child's first dental visit. Choice C ('When the first deciduous teeth are lost') is too late for the first dental visit, as preventive care should start earlier. Choice D ('At the next dental visit of a family member') is not ideal as the child's dental needs should be addressed independently of family members' visits.

Similar Questions