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. After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?

• A. A balance of rest and exercise is important.
• B. I can apply lotion or powder to the incision if it is itchy.
• C. Activities in which falling could occur need to be avoided for two to four weeks.
• D. Large crowds of people need to be avoided for at least two weeks after the surgery.

Correct answer: B

Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.

3. You are dispatched to a residence for a child with respiratory distress. The child is wheezing and has nasal flaring and retractions. His oxygen saturation is 92%. You should:

• A. place the child in a supine position.
• B. administer high-flow oxygen.
• C. begin chest compressions.
• D. administer low-flow oxygen.

Correct answer: B

Rationale: In a scenario where a child presents with respiratory distress, wheezing, nasal flaring, retractions, and an oxygen saturation of 92%, the appropriate intervention is to administer high-flow oxygen. This helps to improve oxygenation and alleviate the respiratory distress the child is experiencing. Placing the child in a supine position can worsen their condition by affecting their ability to breathe effectively. Chest compressions are not indicated in this case as the child is not in cardiac arrest. Administering low-flow oxygen may not provide adequate oxygenation for a child in respiratory distress with a saturation of 92%. Therefore, the priority is to administer high-flow oxygen to improve oxygen levels and support the child's breathing.

4. Your assessment of a newborn reveals cyanosis to the chest and face and a heart rate of 90 beats/min. What should you do first?

• A. Dry the infant briskly.
• B. Suction the mouth.
• C. Begin artificial ventilations.
• D. Begin chest compressions.

Correct answer: C

Rationale: In a newborn with cyanosis to the chest and face and a heart rate of 90 beats/min, the priority action is to begin artificial ventilations. A heart rate below 100 beats/min with cyanosis indicates a need for immediate respiratory support to improve oxygenation. Drying the infant briskly or suctioning the mouth may be necessary later but are not the initial priority. Chest compressions are not indicated as the heart rate is above 60 beats/min.

5. What is the pattern of fever in enteric fever?

• A. Intermittent fever
• B. Relapsing fever
• C. Pel-Ebstein fever
• D. Continuous fever

Correct answer: D

Rationale: Enteric fever, caused by Salmonella typhi or paratyphi, is characterized by a continuous fever pattern. The fever typically persists without significant fluctuations, distinguishing it from diseases with intermittent or relapsing fever patterns. Pel-Ebstein fever, a cyclic pattern of fever seen in Hodgkin's lymphoma, is not associated with enteric fever. Relapsing fever is a characteristic of diseases like Borrelia recurrentis infection. Intermittent fever is seen in conditions like malaria.

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