Nursing Elites

1. When ventilating an apneic 3-year-old child with a bag-valve mask device, what is the MOST important action to take?

• A. Avoid hyperventilation and ensure adequate chest rise.
• B. Squeeze the bag with both hands and use a pediatric mask.
• C. Immediately insert an oropharyngeal airway.
• D. Provide one breath every 3 to 5 seconds.

Correct answer: A

Rationale: When ventilating an apneic child, the most important action is to avoid hyperventilation and ensure adequate chest rise. Hyperventilation can lead to decreased cardiac output and increased intracranial pressure. Adequate chest rise confirms effective ventilation and minimizes the risk of complications. Choice B is incorrect because using both hands to squeeze the bag may not ensure proper ventilation and can lead to complications. Choice C is incorrect as inserting an oropharyngeal airway is not the initial action in ventilating an apneic child with a bag-valve mask. Choice D is incorrect as providing ventilations every 3 to 5 seconds may not be appropriate for effective ventilation in a pediatric patient.

2. A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?

• A. Liver
• B. Kidney
• C. Pancreas
• D. Spleen

Correct answer: D

Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.

3. When assessing a newborn for jaundice, which area should be examined?

• A. Legs and feet
• B. Chest and abdomen
• C. Face and sclera
• D. Back and buttocks

Correct answer: C

Rationale: When assessing a newborn for jaundice, the healthcare provider should examine the face and sclera. Jaundice is often first noticeable in these areas due to the buildup of bilirubin, causing a yellowish discoloration of the skin and eyes. Examining the legs and feet (Choice A) is not the most appropriate area for identifying jaundice in newborns. Similarly, the chest and abdomen (Choice B) are not the primary areas where jaundice is usually observed. Checking the back and buttocks (Choice D) is also not as useful as examining the face and sclera when assessing for jaundice in newborns.

4. You arrive at the scene shortly after a 3-year-old female experienced a seizure. The child, who is being held by her mother, is conscious and crying. The mother tells you that her daughter has been ill recently and has a temperature of 102.5°F. What is the MOST appropriate treatment for this child?

• A. Oxygen via non-rebreathing mask, place the child in a tub of cold water to lower her body temperature, and transport.
• B. Oxygen via the blow-by technique, transport, and request a paramedic intercept so an anticonvulsant drug can be given.
• C. Oxygen via non-rebreathing mask, avoid any measures to lower the child's body temperature, and transport at once.
• D. Oxygen via the blow-by technique, remove clothing to help reduce her fever, and transport with continuous monitoring.

Correct answer: D

Rationale: The most appropriate treatment for a child who has experienced a seizure and has a fever includes administering oxygen via the blow-by technique, removing clothing to help reduce fever, and transporting the child with continuous monitoring. Choice A is incorrect because placing the child in a tub of cold water can lead to hypothermia and is not recommended for fever reduction. Choice B is incorrect as requesting an anticonvulsant drug without proper evaluation and assessment by a healthcare provider is not appropriate. Choice C is incorrect as avoiding measures to lower the child's body temperature can worsen the situation in case of febrile seizures. Therefore, the best course of action is to provide oxygen via the blow-by technique, remove excess clothing to reduce fever, and transport the child while continuously monitoring her condition.

5. To prevent diarrhea in children, a vaccine is available against which of the following?

• A. Adenovirus
• B. Rotavirus
• C. Enterovirus
• D. All of the above

Correct answer: B

Rationale: The correct answer is B - Rotavirus. Rotavirus vaccine is available to prevent diarrhea in children. Rotavirus is a common cause of severe diarrhea in infants and young children globally, and vaccination has been shown to be effective in reducing the burden of this disease. Choices A and C are incorrect because there is no specific vaccine available for Adenovirus or Enterovirus to prevent diarrhea in children. Choice D is incorrect because while vaccines are available for some viruses that can cause diarrhea in children, not all mentioned in the choices have a specific vaccine available.

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