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. A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:

• A. Ventilate through the tracheostomy tube.
• B. Place an oxygen mask over the tracheostomy tube.
• C. Remove the tracheostomy tube and clean it.
• D. Carefully suction the tracheostomy tube.

Correct answer: D

Rationale: In this scenario, the 4-year-old boy with a tracheostomy tube is showing signs of respiratory distress, including intercostal retractions, a low heart rate, and decreased oxygen saturation. The gurgling sound indicates a possible airway obstruction. Correctly, the immediate action should be to carefully suction the tracheostomy tube. Suctioning can help clear any secretions or obstructions, thus improving the child's ability to breathe effectively. Ventilating through the tube, placing an oxygen mask over it, or removing and cleaning the tube would not address the potential obstruction and could worsen the respiratory distress.

3. Mrs. Byers tells the nurse that she is very worried because her 2-year-old child does not finish his meals. What should the nurse advise the mother?

• A. Make the child seat with the family in the dining room until he finishes his meal
• B. Provide quiet environment for the child before meals
• C. Do not give snacks to the child before meals
• D. Put the child on a chair and feed him

Correct answer: C

Rationale: Providing a quiet environment can help the child focus on eating.

4. Which of the following is not an infectious cause of diarrhea?

• A. Allergy
• B. Bacteria
• C. Parasite
• D. Virus

Correct answer: A

Rationale: The correct answer is A: Allergy. Allergy is not an infectious cause of diarrhea. Diarrhea caused by bacteria, parasites, and viruses is due to infection, while an allergy triggers an immune response that can lead to diarrhea but is not caused by an infectious agent. Choices B, C, and D are incorrect because bacteria, parasites, and viruses are known infectious causes of diarrhea, resulting from infections by these microorganisms.

5. Serwaa, a 26-year-old mother, has brought her daughter to the OPD with signs of lower respiratory tract infection. Which of the following diagnoses is NOT typically associated with lower respiratory tract infections for her daughter?

• A. Pneumonia
• B. Asthma
• C. Bronchiolitis
• D. Coryza

Correct answer: D

Rationale: Coryza, also known as the common cold, is a viral infection that primarily affects the upper respiratory tract and is not typically associated with lower respiratory tract infections. Pneumonia, asthma, and bronchiolitis are conditions that commonly affect the lower respiratory tract, causing symptoms like cough, difficulty breathing, and chest pain.

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