Nursing Elites

1. When assessing a 30-year-old female who was sexually assaulted, what is the MOST important action for you to take?

• A. Have a female healthcare provider perform the assessment.
• B. Advise against showering or changing clothes.
• C. Acknowledge that the patient is a potential crime scene.
• D. Ensure that all life-threatening injuries are treated.

Correct answer: D

Rationale: In cases of sexual assault, the priority is to address any life-threatening injuries first before proceeding with other aspects of care. Although preserving evidence and approaching the situation with sensitivity are crucial, immediate treatment of life-threatening conditions takes precedence to ensure the patient's well-being and safety. Having a female healthcare provider, advising against showering or changing clothes, and acknowledging the patient as a potential crime scene are important but secondary considerations compared to addressing any life-threatening injuries promptly.

2. What are the MOST important initial steps in assessing and managing a newborn?

• A. Drying and warming the infant, obtaining an APGAR score.
• B. Clearing the airway, keeping the infant warm.
• C. Suctioning the airway, obtaining a heart rate.
• D. Keeping the infant warm, counting respirations.

Correct answer: B

Rationale: The most crucial initial steps in assessing and managing a newborn involve clearing the airway to ensure proper breathing and keeping the infant warm to maintain body temperature. Airway clearance helps prevent respiratory distress, while warmth is essential to prevent hypothermia, a common issue in newborns. These steps are vital in the immediate care of a newborn to support their transition to extrauterine life and ensure their well-being. Choice A is incorrect because obtaining an APGAR score is important but not as critical as clearing the airway. Choice C is incorrect as suctioning the airway is not always necessary and obtaining a heart rate is secondary to ensuring a clear airway and warmth. Choice D is incorrect because counting respirations is not as immediate and crucial as clearing the airway.

3. During your assessment of a woman in labor, you see the baby's arm protruding from the vagina. The mother tells you that she needs to push. You should:

• A. gently push the protruding arm back into the vagina.
• B. encourage the mother to push and give her high-flow oxygen.
• C. insert your gloved fingers into the vagina and try to turn the baby.
• D. cover the arm with a sterile towel and transport immediately.

Correct answer: D

Rationale: When encountering a protruding limb during delivery, it is crucial to recognize this as an emergency situation. The correct action is to cover the limb with a sterile towel to prevent injury and transport the mother immediately to a medical facility. Attempting to push the limb back into the vagina or trying to manipulate the baby's position can be harmful and delay necessary medical intervention. Encouraging the mother to push and providing high-flow oxygen is not appropriate in this scenario as immediate transport is essential to ensure the safety of both the mother and the baby.

4. When responding to a call for a 2-year-old child who fell from a second-story window, with the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's:

• A. chest.
• B. head.
• C. lower extremities.
• D. abdomen.

Correct answer: B

Rationale: In a scenario where a young child falls from a significant height like a second-story window, the primary injury is more likely to be to the head. This is because young children have proportionately larger head sizes compared to their body, making them more susceptible to head injuries in such falls. The chest (Choice A), lower extremities (Choice C), and abdomen (Choice D) are less likely to sustain the primary injury in this scenario, as the impact of the fall and the child's anatomy predispose the head to be the most affected area.

5. Use the scenario to answer questions 13-18. A patient has come to the OPD with complaints of anaesthesia and paresthesia of the lower limbs. After laboratory investigations, the doctor has diagnosed the patient with Diabetes Mellitus but failed to specify whether it is type 1 or type 2. Onset of Type 1 diabetes is characterized by:

• A. Occurs after pubertal onset in the majority of cases
• B. Occurs when parents are poor
• C. Occurs at an early age
• D. Occurs after childbirth

Correct answer: A

Rationale: Type 1 diabetes typically occurs after pubertal onset. This form of diabetes is most commonly diagnosed in individuals under the age of 30, with a peak incidence in the mid-teens to early 20s. Puberty is a period of hormonal changes and growth, which can trigger the onset of type 1 diabetes due to the stress it places on the body's insulin-producing cells.

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