Nursing Elites

1. 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.

2. Which of the following are not infectious causes of diarrhea?

• A. Allergy
• B. Bacteria
• C. Parasite
• D. Virus

Correct answer: A

Rationale: Diarrhea can be caused by various infectious agents such as bacteria, parasites, and viruses. Allergy, on the other hand, is a non-infectious cause of diarrhea. When an individual with a food allergy consumes the specific food they are allergic to, it can trigger diarrhea as a part of the allergic reaction.

3. Atta, who weighs 20kg, has been prescribed amoxicillin 500 mg b.i.d. The drug information indicates a daily dose of amoxicillin at 50 mg/kg/day in two divided doses. What is the safest dose in milligrams for this child?

• A. 1000 mg
• B. 750 mg
• C. 500 mg
• D. 250 mg

Correct answer: A

Rationale: To calculate the safest dose of amoxicillin for Atta, we multiply the weight (20kg) by the daily dose (50 mg/kg/day) which equals 1000 mg/day. Since the dose is to be given in two divided doses, the safest dose for each administration would be 500 mg. Therefore, the correct answer is 1000 mg, as it aligns with the prescribed dose for this child based on weight and dosing guidelines. Choice B, 750 mg, is incorrect as it does not match the calculated daily dose. Choice C, 500 mg, is incorrect as it represents the safest dose for each administration, not the total daily dose. Choice D, 250 mg, is incorrect as it is below the calculated daily dose required for the child.

4. A postpartum client is experiencing heavy lochia and a boggy uterus. What should be the nurse's initial action?

• A. Administer a uterotonic medication
• B. Encourage the client to void
• C. Perform fundal massage
• D. Increase the client's fluid intake

Correct answer: C

Rationale: The correct initial action for a postpartum client experiencing heavy lochia and a boggy uterus is to perform fundal massage. Fundal massage helps to firm the uterus and reduce bleeding by promoting uterine contractions, which can assist in preventing postpartum hemorrhage. Administering uterotonic medication may be necessary in some cases but should not be the initial action. Encouraging the client to void and increasing fluid intake can be important interventions but are not the priority in this situation where immediate uterine firmness is needed to control bleeding.

5. Which of the following is an indication of lower respiratory infection?

• A. Cough
• B. Fever
• C. Inability to lie supine
• D. Shortness of breath

Correct answer: C

Rationale: Inability to lie supine is a significant indication of lower respiratory infection. This symptom often occurs due to breathing difficulties and discomfort experienced by individuals with lower respiratory infections, such as pneumonia or bronchitis. It can be caused by lung inflammation, consolidation, or fluid buildup in the lungs, making lying flat uncomfortable or difficult. Monitoring a patient's ability to lie flat can provide valuable information about the severity and progression of a lower respiratory infection.

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