Nursing Elites

1. You arrive at a residence shortly after a 4-year-old boy experienced an apparent febrile seizure. The child is alert and crying. His skin is flushed, hot, and moist. His mother tells you that the seizure lasted about 2 minutes. You should:

• A. provide supportive care and transport.
• B. give him acetaminophen or ibuprofen.
• C. begin rapid cooling measures at once.
• D. allow the mother to take her child to the doctor.

Correct answer: A

Rationale: After a febrile seizure, the recommended course of action is to provide supportive care and transport the child to a medical facility. Supportive care may include ensuring a safe environment, monitoring the child, and seeking medical evaluation to determine the underlying cause of the seizure and appropriate management.

2. You are dispatched to a residence for a 4-year-old female who is sick. Your assessment reveals that she has increased work of breathing and is making a high-pitched sound during inhalation. Her mother tells you that she has been running a high fever for the past 24 hours. Your MOST immediate concern should be:

• A. determining if the child has a history of croup.
• B. preparing to treat her for a febrile seizure.
• C. assessing the need for ventilation assistance.
• D. taking her temperature to see how high it is.

Correct answer: C

Rationale: In a child with increased work of breathing, a high-pitched sound during inhalation, and a high fever, upper airway obstruction should be suspected. The child's condition may require immediate ventilation assistance to ensure adequate oxygenation and ventilation. Therefore, the most immediate concern in this scenario is to assess the need for ventilation assistance.

3. Which of the following is not a clinical type of diarrhea?

• A. Acute diarrhea
• B. Bloody diarrhea
• C. Persistent diarrhea
• D. Secretory diarrhea

Correct answer: B

Rationale: Bloody diarrhea is not typically classified as a clinical type of diarrhea. The clinical types of diarrhea commonly include acute, persistent, and secretory diarrhea, which are characterized by different mechanisms and durations. Bloody diarrhea usually indicates the presence of blood in the stool, which can be a sign of various underlying conditions but is not a specific clinical type of diarrhea.

4. Management for a woman presenting with a prolapsed umbilical cord includes all of the following, EXCEPT:

• A. lifting the baby's head off the umbilical cord.
• B. placing the mother in a position that elevates her hips.
• C. ensuring that the cord stays moist during transport.
• D. relieving pressure off the cord by gently pulling on it.

Correct answer: D

Rationale: In cases of prolapsed umbilical cord, it is crucial to manage the situation promptly. The correct steps include lifting the baby's head off the umbilical cord to reduce pressure, placing the mother in a position that elevates her hips to relieve pressure on the cord, and ensuring that the cord stays moist. Pulling on the cord is not recommended as it can further compromise fetal circulation and should be avoided. Therefore, relieving pressure off the cord by gently pulling on it is not a recommended management approach in cases of prolapsed umbilical cord.

5. 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.

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