Nokea
The nurse begins CPR on a 5-year-old unresponsive client. When the emergency response team arrives, the child continues to have no respiratory effort but has a heart rate of 50 with cyanotic legs. The team should next:
- A. Discontinue compressions but continue administering breaths with a bag-mask device.
- B. Establish an intravenous line with a large bore needle while preparing the defibrillator.
- C. Begin 2-person CPR at a ratio of 2 breaths to 15 compressions.
- D. Begin 2-person CPR at a ratio of 2 breaths to 30 compressions.
Correct Answer: C
Rationale: For a 5-year-old with a heart rate of 50 (bradycardia) and no respiratory effort, 2-person CPR with a ratio of 2 breaths to 15 compressions is appropriate to optimize oxygenation and circulation.
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Which of the following is appropriate language development for an 8-month-old? The child should be:
- A. Saying 'dada' and 'mama' specifically ('dada' to father and 'mama' to mother).
- B. Saying three other words besides 'mama' and 'dada.'
- C. Saying 'dada' and 'mama' nonspecifically.
- D. Saying 'ball' when parents point to a ball.
Correct Answer: C
Rationale: At 8 months, infants typically say 'dada' and 'mama' nonspecifically, as specific use develops closer to 12 months.
Which one of the following children is at most risk for sudden infant death syndrome (SIDS)?
- A. Infant who is 3 months old.
- B. 2-year-old who has apnea lasting up to 5 seconds.
- C. First-born child whose parents are in their 40s.
- D. 6-month-old who has had two bouts of pneumonia.
Correct Answer: A
Rationale: A 3-month-old infant is at the highest risk for SIDS, as the peak incidence occurs between 2 and 4 months of age.
Which of following should the nurse perform to help alleviate a child's joint pain associated with rheumatic fever?
- A. Maintaining the joints in an extended position.
- B. Applying gentle traction to the child's affected joints.
- C. Supporting proper alignment with rolled pillows.
- D. Using a bed cradle to avoid the weight of bed linens on joints.
Correct Answer: D
Rationale: A bed cradle reduces pressure from bed linens, alleviating joint pain in rheumatic fever. Other options may not effectively reduce pain or could cause discomfort.
The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, 'I hate you.' Which of the following would be most appropriate:
- A. Tell the parents they will need to wait out in the lobby.
- B. Ask the charge nurse to assign this client to another nurse.
- C. Reassure the parents that this is a normal behavior under the circumstances.
- D. Ask the parents to discipline the child so that the physician can treat her.
Correct Answer: C
Rationale: Such behavior is a normal stress response in a young child experiencing pain and fear in an emergency setting.
The mother of a 4-year-old expresses concern that her child may be hyperactive. She describes the child as always in motion, constantly dropping and spilling things. Which of the following actions would be appropriate at this time?
- A. Determine whether there have been any changes at home.
- B. Explain that this is not unusual behavior.
- C. Explore the possibility that the child is being abused.
- D. Assess that the child be seen by a pediatric neurologist.
Correct Answer: A
Rationale: Assessing home changes helps identify triggers for the behavior before assuming pathology.