Nursing Elites

1. In a case where a limb is protruding from a mother's vagina during active labor, how should this condition be managed?

• A. Positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport
• B. Positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport
• C. Applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord
• D. Giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur

Correct answer: B

Rationale: When a limb is protruding from the vagina during active labor, the appropriate management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord, reducing the risk of compromising fetal blood flow and oxygenation. Administering oxygen is essential to maintain oxygenation levels for both the mother and the fetus. Providing transport to a healthcare facility equipped to manage this obstetric emergency is crucial for ensuring a safe delivery. Choice A is incorrect because a semi-Fowler's position does not effectively relieve pressure on the umbilical cord. Choice C is incorrect as applying traction to the protruding limb can lead to injury or complications for both the mother and the fetus. Choice D is incorrect because attempting to manipulate the limb without proper positioning and preparation can worsen the situation and increase risks during delivery.

2. The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?

• A. Most childhood cancers affect tissues rather than organs.
• B. Childhood cancers are usually localized when found.
• C. Unlike adult cancers, childhood cancers are less responsive to treatment.
• D. The majority of childhood cancers can be prevented.

Correct answer: A

Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers can be localized or spread, similar to adult cancers. Choice C is incorrect because childhood cancers can be highly responsive to treatment, especially when diagnosed early. Choice D is incorrect because the majority of childhood cancers cannot be prevented as they are often due to genetic mutations or unknown causes.

3. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

• A. We should give this drug after he eats something.
• B. We need to watch carefully for possible infections.
• C. The drug should not be stopped abruptly.
• D. He might experience weight gain with this drug.

Correct answer: A

Rationale: Giving prednisone with food helps prevent gastrointestinal upset. Therefore, the correct statement is that the drug should be given after the child eats something, not before. Watching for infections is important due to prednisone's immunosuppressive effects, making choice B correct. Choice C is accurate because prednisone should be tapered off gradually to prevent withdrawal symptoms. Weight gain is a common side effect of prednisone, so choice D is also correct. The incorrect statement is choice A, as prednisone should be administered after a meal.

4. After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?

• A. Thickened formula 24 hours after surgery
• B. Withholding feedings for the first 24 hours
• C. Regular formula feeding within 24 hours after surgery
• D. Additional glucose feedings as desired after the first 24 hours

Correct answer: C

Rationale: Following surgery for hypertrophic pyloric stenosis (HPS) in infants, it is appropriate to resume regular formula feeding within 24 hours postoperatively to support recovery. This helps maintain adequate nutrition and hydration for the infant. Choice A is incorrect because thickened formula may not be necessary and could potentially cause issues postoperatively. Choice B is incorrect as withholding feedings for the first 24 hours can lead to nutritional deficiencies and delay recovery. Choice D is inappropriate as additional glucose feedings are not typically indicated postoperatively for infants with HPS and may not provide the necessary nutrition needed for recovery.

5. A parent asks the nurse what to do for their child who has an earache and fever. What should the nurse suggest?

• A. Applying a warm compress to the affected ear
• B. Giving the child a cold drink
• C. Administering acetaminophen
• D. Taking the child to the emergency department

Correct answer: A

Rationale: Applying a warm compress to the affected ear is a recommended home remedy for earaches as it can help reduce pain and discomfort. The warmth can also help improve circulation and promote drainage if there is fluid buildup. Giving a cold drink (Choice B) is not typically beneficial for earaches and fever. Administering acetaminophen (Choice C) can help reduce fever and alleviate pain, but addressing the earache directly with a warm compress is a more targeted approach. Taking the child to the emergency department (Choice D) is not necessary for a common earache unless there are severe symptoms or complications present.

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