Nursing Elites

1. 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.

2. After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?

• A. A balance of rest and exercise is important.
• B. I can apply lotion or powder to the incision if it is itchy.
• C. Activities in which falling could occur need to be avoided for two to four weeks.
• D. Large crowds of people need to be avoided for at least two weeks after the surgery.

Correct answer: B

Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.

3. Which of the following is the MOST detrimental effect of gastric distention in infants and children?

• A. Tracheal rupture.
• B. Less effective chest compressions.
• C. Decreased ventilatory volume.
• D. Acute rupture of the diaphragm.

Correct answer: C

Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.

4. A healthcare provider is educating a new mother on discharge. They told the mother to look for the following danger signs.

• A. Poor Feeding
• B. High Temperature
• C. Convulsions
• D. All of the Above

Correct answer: D

Rationale: It is crucial for new mothers to be aware of potential danger signs after discharge. Poor feeding, high temperature, and convulsions are all critical symptoms that should prompt immediate medical attention. Poor feeding may indicate issues with feeding or underlying health problems. High temperature could be a sign of infection or illness. Convulsions are a serious symptom that could indicate neurological problems or other medical emergencies. By being vigilant and recognizing these signs early, the mother can help ensure the well-being of her newborn. Therefore, the correct answer is 'All of the Above' as all these signs require prompt medical attention to ensure the baby's health and safety.

5. Which of the following is an indication of lower respiratory infection?

• A. Cough
• B. Fever
• C. Inability to lie supine
• D. Shortness of breath

Correct answer: C

Rationale: Inability to lie supine is a significant indication of lower respiratory infection. This symptom often occurs due to breathing difficulties and discomfort experienced by individuals with lower respiratory infections, such as pneumonia or bronchitis. It can be caused by lung inflammation, consolidation, or fluid buildup in the lungs, making lying flat uncomfortable or difficult. Monitoring a patient's ability to lie flat can provide valuable information about the severity and progression of a lower respiratory infection.

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