Nursing Elites

1. What is a priority discharge instruction for a parent of a child experiencing the first episode of asthma?

• A. Asthma can be prevented by avoiding environmental and emotional triggers
• B. Asthma decreases the size of the airway causing distress
• C. Bronchodilators can cause tachycardia and restlessness
• D. If an attack occurs at home, the child should sit or stand

Correct answer: A

Rationale: Educating parents about avoiding triggers is a crucial part of managing asthma in children to prevent future asthma attacks. By identifying and minimizing exposure to triggers, parents can help reduce the risk of asthma exacerbations and improve the child's overall quality of life.

2. You are assessing a 26-year-old woman who is 38 weeks pregnant and is in labor. She tells you that she was pregnant once before but had a miscarriage at 19 weeks. You should document her obstetric history as:

• A. gravida 2, para 1.
• B. gravida 2, para 0.
• C. gravida 1, para 1.
• D. gravida 0, para 2.

Correct answer: B

Rationale: In obstetrics, gravida indicates the number of pregnancies, including the current one. Para indicates the number of pregnancies carried to viability (20 weeks or more). Since the patient has been pregnant twice but only carried one pregnancy past 20 weeks, her obstetric history should be documented as gravida 2, para 0. The miscarriage at 19 weeks does not contribute to the para count. Choice A (gravida 2, para 1) would indicate that she has had two pregnancies with one resulting in a live birth, which is incorrect. Choice C (gravida 1, para 1) would indicate that she has had one pregnancy with one live birth, which does not reflect her obstetric history. Choice D (gravida 0, para 2) would indicate that she has never been pregnant past 20 weeks, which is also inaccurate.

3. In the Integrated Management of Neonatal and Childhood Illnesses, one of the things to look for is danger signs. Which of the following will you consider a danger sign in a child?

• A. The child vomits everything
• B. A child with diarrhea
• C. A child with headache
• D. All of the above

Correct answer: A

Rationale: The correct answer is A: 'The child vomits everything.' Vomiting everything is considered a danger sign in a child as it can lead to dehydration and other serious complications. Recognizing this sign early can help in timely intervention and management of the child's condition. Choices B and C are incorrect as diarrhea and headache, while concerning, are not specific danger signs highlighted in the Integrated Management of Neonatal and Childhood Illnesses.

4. When preventing cardiac arrest in infants and small children, the primary focus should be on:

• A. Providing immediate transport.
• B. Ensuring adequate ventilation.
• C. Keeping the child warm.
• D. Avoiding upsetting the child.

Correct answer: B

Rationale: The correct approach to prevent cardiac arrest in infants and small children is to ensure adequate ventilation. In these cases, maintaining proper oxygenation and ventilation is crucial for sustaining life. Providing immediate transport, keeping the child warm, or avoiding upsetting the child are important considerations but ensuring adequate ventilation takes precedence in preventing cardiac arrest and supporting the child's vital functions.

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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