Nursing Elites

1. Upon delivery of a baby's head, you see that the umbilical cord is wrapped around its neck. Initial treatment for this condition should include:

• A. Clamping and cutting the umbilical cord.
• B. Gently pulling on the cord to facilitate removal.
• C. Trying to remove the cord from around the neck.
• D. Keeping the cord moist and providing rapid transport.

Correct answer: C

Rationale: When encountering a situation where the umbilical cord is wrapped around a baby's neck upon delivery, the initial treatment should involve trying to remove the cord from around the neck gently. It is crucial to handle this situation delicately to avoid causing harm to the baby. Attempting to ease the cord over the baby's head without pulling or tightening can help prevent potential complications associated with cord compression. Choice A, clamping and cutting the umbilical cord, is not recommended as it can lead to abrupt deprivation of oxygen to the baby. Choice B, gently pulling on the cord, can worsen the situation by tightening the cord around the baby's neck. Choice D, keeping the cord moist and providing rapid transport, is not the immediate concern and does not address the potential risks of cord compression during delivery. Therefore, the priority is to carefully attempt to remove the cord from around the baby's neck to ensure a safe delivery.

2. A mother of a 2-year-old child complains that her child has a fever, sore mouth, and red eye. What will be the possible diagnosis?

• A. TB
• B. Meningitis
• C. Measles
• D. Pertussis

Correct answer: C

Rationale: The correct answer is C, Measles. Measles commonly presents with symptoms such as fever, sore mouth, and red eyes. These characteristic symptoms help differentiate measles from the other conditions listed. Tuberculosis (Choice A) typically presents with respiratory symptoms, Meningitis (Choice B) commonly presents with symptoms like headache, neck stiffness, and altered mental status, while Pertussis (Choice D) is characterized by severe coughing spells. Therefore, in this case, the symptoms described align more closely with measles.

3. In contrast to the contractions associated with true labor, Braxton-Hicks contractions:

• A. generally follow rupture of the amniotic sac and occur with regularity.
• B. may be intensified by activity and are accompanied by a pink discharge.
• C. do not increase in intensity and are alleviated by a change in position.
• D. consistently become stronger and are not alleviated by changing position.

Correct answer: C

Rationale: Braxton-Hicks contractions are irregular and usually do not increase in intensity. Unlike true labor contractions, they tend to alleviate with a change in position, making option C the correct choice. Choices A, B, and D are incorrect because Braxton-Hicks contractions do not follow rupture of the amniotic sac, are not intensified by activity or accompanied by a pink discharge, and do not consistently become stronger or are not alleviated by changing position.

4. The caregiver is teaching a new mother about infant safety. Which statement indicates that further teaching is needed?

• A. I will place my baby on their back to sleep.
• B. I will keep soft toys and pillows out of the crib.
• C. I will use a car seat for every car ride.
• D. I will allow my baby to sleep in my bed.

Correct answer: D

Rationale: Allowing a baby to sleep in an adult bed increases the risk of suffocation and Sudden Infant Death Syndrome (SIDS). It is safer for infants to sleep on a firm, flat surface in their own crib or bassinet to reduce the risk of accidental suffocation or strangulation. Therefore, the caregiver should be advised against co-sleeping with the infant to ensure the baby's safety.

5. Following delivery of a newborn and placenta, you note that the mother has moderate vaginal bleeding. The mother is conscious and alert, and her vital signs are stable. Treatment for her should include:

• A. carefully packing the vagina with sterile dressings.
• B. massaging the uterus if signs of shock develop.
• C. treating her for shock and providing rapid transport.
• D. administering oxygen and massaging the uterus.

Correct answer: D

Rationale: Administering oxygen and massaging the uterus are appropriate interventions to manage postpartum bleeding. Oxygen helps support tissue perfusion, and uterine massage can aid in uterine contraction, controlling bleeding. These actions are indicated when the mother experiences moderate vaginal bleeding post-delivery, as described in the scenario. Careful monitoring for signs of shock should continue while these interventions are implemented to ensure the mother's condition remains stable. Choices A and B are incorrect because packing the vagina with sterile dressings is not recommended for postpartum bleeding unless it is severe and immediate action is needed, while massaging the uterus is a proactive approach and should not be delayed until signs of shock develop. Choice C is also incorrect as rapid transport is not the primary intervention in this scenario where the mother is conscious, alert, and stable, and the focus should be on immediate management of the bleeding.

Similar Questions