Nursing Elites

1. Which artery should you palpate when assessing for a pulse in an unresponsive 6-month-old patient?

• A. Radial
• B. Brachial
• C. Femoral
• D. Carotid

Correct answer: B

Rationale: When assessing for a pulse in an unresponsive 6-month-old patient, the brachial artery is the recommended site for palpation. This is because the brachial artery is easily accessible and provides a reliable indication of the patient's circulatory status in infants.

2. What percentage of total body surface area has been burned in a 5-year-old child who experienced partial-thickness burns to his head, anterior chest, and both upper extremities?

• A. 45%
• B. 63%
• C. 72%
• D. 54%

Correct answer: A

Rationale: According to the pediatric rule of nines, the head and neck represent 18%, the anterior chest and abdomen 18%, and each arm 9%. By adding these percentages (18% + 18% + 9% + 9% = 45%), we find that 45% of the total body surface area has been burned in this child.

3. 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.

4. What action should you take if a newborn's heart rate is 50 beats/min?

• A. Begin chest compressions.
• B. Reassess in 30 seconds.
• C. Administer blow-by oxygen.
• D. Start positive-pressure ventilations.

Correct answer: D

Rationale: If a newborn's heart rate is below 60 beats per minute, the appropriate action is to start positive-pressure ventilations. Ventilations help deliver oxygen to the newborn's body and support respiratory function, which is critical in cases of bradycardia. Chest compressions are not recommended until the heart rate is below 60 despite adequate ventilation. Reassessment is essential but not the immediate action required in this scenario. Administering blow-by oxygen alone may not effectively address the underlying cause of bradycardia, making positive-pressure ventilations the priority intervention in this case.

5. The healthcare provider is caring for a newborn who is 2 days old. Which finding should be reported to the healthcare provider?

• A. Yellowing of the skin
• B. Presence of a small amount of blood in the diaper
• C. Peeling skin on the hands and feet
• D. Intermittent episodes of sneezing

Correct answer: A

Rationale: Yellowing of the skin may indicate jaundice in a newborn, which can be a sign of an underlying health issue such as an elevated bilirubin level. It is essential to report this finding to the healthcare provider for further assessment and appropriate management to prevent complications.

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