Nursing Elites

1. You are caring for a 6-year-old child with a possible fractured arm and have reason to believe that the child was abused. How should you manage this situation?

• A. Inform the parents of your suspicions.
• B. Transport the child to the hospital regardless of the parents' wishes.
• C. Call the police and have the parents arrested.
• D. Advise the parents that the child needs to be transported.

Correct answer: D

Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported for further evaluation and care is the appropriate initial step. This ensures that the child receives necessary medical attention while also addressing the suspicion of abuse through proper channels. It is essential to involve appropriate authorities and follow established procedures to protect the child and investigate any potential abuse further.

2. A new parent reports to the nurse that the baby looks cross-eyed several times a day. The nurse teaches the parents that this finding should resolve in how long?

• A. 2 months
• B. 2 weeks
• C. 1 year
• D. 4 months

Correct answer: D

Rationale: Transient strabismus, causing the baby to look cross-eyed, is due to poor neuromuscular control of the eye muscles. This condition typically resolves on its own within 3 to 4 months as the infant's neuromuscular control improves. Parents should be reassured that this is a common and temporary issue in infants. Choice A is incorrect as it is too long for the resolution of transient strabismus. Choice B is incorrect as 2 weeks is too short for resolution. Choice C is incorrect as 1 year is too long for transient strabismus to resolve.

3. Sometimes, people with congestive heart failure develop arrhythmias of the heart. These irregular rhythms can be conducive to developing a blood clot. Physicians frequently treat people with 'blood thinning' medicines that require regulation of the density of the blood. Which of these is the name for a blood-thinner?

• A. Erythromycin
• B. Tetracycline
• C. Warfarin
• D. Amoxicillin

Correct answer: C

Rationale: Warfarin is a medication commonly used as a blood thinner to prevent blood clot formation. It works by inhibiting the clotting factors in the blood, thereby reducing the risk of clot formation and helping in the management of conditions like congestive heart failure and arrhythmias. Choices A, B, and D are antibiotics and do not have blood-thinning properties like Warfarin.

4. The healthcare provider is teaching a new mother how to care for her newborn's umbilical cord. Which instruction should be included?

• A. Keep the cord dry and exposed to air
• B. Clean the cord with alcohol at every diaper change
• C. Cover the cord with a sterile dressing
• D. Submerge the cord in water during baths

Correct answer: A

Rationale: Keeping the umbilical cord dry and exposed to air is the correct instruction because it promotes faster healing. Moisture can delay the healing process and increase the risk of infection. Cleaning the cord with alcohol at every diaper change or covering it with a sterile dressing can actually impede the healing process by preventing airflow. Submerging the cord in water during baths is not recommended as it can introduce moisture and increase the risk of infection.

5. Which of the following statements regarding 2-rescuer child CPR is correct?

• A. The chest should be compressed with one hand, and a compression-to-ventilation ratio of 30:2 should be used.
• B. The chest should not be allowed to fully recoil in between compressions.
• C. A compression-to-ventilation ratio of 15:2 should be used if an advanced airway is in place.
• D. Compress the chest with one or two hands to a depth equal to one-third the diameter of the chest.

Correct answer: D

Rationale: During 2-rescuer child CPR, it is important to compress the chest with one or two hands to a depth equal to one-third the diameter of the chest. This technique ensures effective chest compressions are being delivered to help circulate blood and oxygenate the child's body. Choice A is incorrect because both hands should be used for chest compressions in 2-rescuer CPR. Choice B is incorrect as allowing the chest to fully recoil between compressions is essential to create negative pressure and facilitate blood flow back to the heart. Choice C is incorrect as the standard compression-to-ventilation ratio for child CPR is 30:2, regardless of whether an advanced airway is in place.

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