Nursing Elites

1. You are called to a local park for a 7-year-old boy with respiratory distress. During your assessment, you find that the patient is wheezing and has widespread hives and facial edema. What should you suspect has occurred?

• A. Poison oak exposure
• B. Allergic reaction
• C. Heat illness
• D. Acute asthma attack

Correct answer: B

Rationale: The presentation of wheezing, widespread hives, and facial edema is consistent with an allergic reaction. These symptoms indicate a systemic response to an allergen, triggering respiratory distress and skin manifestations.

2. 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.

3. 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.

4. A postpartum client is experiencing heavy lochia and a boggy uterus. What should be the nurse's initial action?

• A. Administer a uterotonic medication
• B. Encourage the client to void
• C. Perform fundal massage
• D. Increase the client's fluid intake

Correct answer: C

Rationale: The correct initial action for a postpartum client experiencing heavy lochia and a boggy uterus is to perform fundal massage. Fundal massage helps to firm the uterus and reduce bleeding by promoting uterine contractions, which can assist in preventing postpartum hemorrhage. Administering uterotonic medication may be necessary in some cases but should not be the initial action. Encouraging the client to void and increasing fluid intake can be important interventions but are not the priority in this situation where immediate uterine firmness is needed to control bleeding.

5. The healthcare provider is providing postpartum care to a client who had a vaginal delivery. Which finding would require further assessment?

• A. Perineal swelling
• B. Moderate lochia serosa
• C. Headache unrelieved by analgesics
• D. Breast engorgement

Correct answer: C

Rationale: A headache unrelieved by analgesics can be a sign of a serious condition such as preeclampsia, which is a life-threatening condition characterized by high blood pressure and often protein in the urine. Prompt assessment and intervention are crucial to prevent complications for both the mother and baby.

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