The child is a 2-year-old who fell into a pool. He was retrieved from the pool by a family member but was not breathing. The family member started CPR, and the ambulance brought him to the hospital.

What factors are important in determining the level of hypoxemia that the child may have experienced during the submersion?

Select all that apply.

Temperature of water

The weight of the child

Oxygen concentration of the ambient air

Whether or not anyone witnessed the fall into the pool

The amount of time the child was submerged

Answer and Explanation

Correct Answer : A,E

The level of hypoxemia that the child may have experienced during the submersion depends on several factors, but the most important ones are:

The **temperature of water**: Cold water can induce a diving reﬂex, which lowers the heart rate and oxygen consumption, and may protect the brain from hypoxic injury. Cold water can also cause laryngospasm, which prevents water aspiration but also impairs gas exchange.
The **amount of time the child was submerged**: The longer the submersion, the more severe the hypoxemia and the higher the risk of brain damage and death. The survival rate decreases significantly after 5 minutes of submersion.

The other factors are less relevant or not directly related to the level of hypoxemia:

The **weight of the child**: This may aﬀect the buoyancy and the ability to ﬂoat or swim, but not the oxygen consumption or gas exchange during submersion.
The **oxygen concentration of the ambient air**: This may aﬀect the pre-submersion oxygen saturation, but not the rate of oxygen depletion or gas exchange during submersion.
The **witnessing of the fall into the pool**: This may aﬀect the time to rescue and resuscitation, but not the level of hypoxemia during submersion.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Choice A reason:Asking the mother if any visitors were expected to arrive is important for gathering information but does not directly address the immediate concern of the potentially missing newborn. It should not be the first action.

Choice B reason:Matching ID bands of all infants and mothers on the unit is the correct first action. It is a critical step in ensuring the safety and security of all infants and mothers, helping to prevent any potential mix-ups or missing infants.

Choice C reason:Determining if the newborn is in the nursery is an important step, but it should not precede the matching of ID bands. The first action should be more immediate and comprehensive in ensuring the safety of all patients on the unit.

Choice D reason:Activating the lockdown procedure is a response to a confirmed security threat. In this scenario, the primary concern is the potential misplacement of an infant, not a confirmed security threat, so this should not be the first action taken.

A. An adult who is one day postoperative for a laparoscopic cholecystectomy. B. An older client who is one day postoperative with a colostomy for colon cancer. C. An older adult who is scheduled for foot amputation due to diabetes complications. D. An adult with alcoholism, cirrhosis, and hepatic encephalopathy.

Correct Answer is A

Explanation

Choice A rationale:

Assigning a client who is one day postoperative for a laparoscopic cholecystectomy to the practical nurse (PN) is appropriate. This procedure is minimally invasive, and the client is likely stable, requiring routine postoperative care such as wound assessment, pain management, and monitoring for any signs of complications.

Choice B rationale:

An older client who is one day postoperative with a colostomy for colon cancer may have complex postoperative needs, including colostomy care, monitoring for complications, and pain management. This level of care is usually within the scope of the registered nurse (RN) rather than a practical nurse (PN).

Choice C rationale:

An older adult who is scheduled for foot amputation due to diabetes complications is likely to have complex care needs, including wound care, diabetes management, and potential complications. This client would require the expertise of an RN rather than a PN.

Choice D rationale:

An adult with alcoholism, cirrhosis, and hepatic encephalopathy may have complex medical and psychosocial issues that require specialized nursing care. This client's condition is not appropriate for a practical nurse (PN) to manage, and the care should be provided by an RN or other specialized healthcare provider.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A new mother on the postpartum unit runs out of the room screaming that her newborn infant's crib is empty and the baby is missing. Which action should the nurse take first?

Correct Answer is B

Explanation

Which client is best to assign to the practical nurse (PN) who is assisting the registered nurse (RN) with the care of a group of clients?

Correct Answer is A

Explanation

A client is admitted with an exacerbation of heart failure secondary to chronic obstructive pulmonary disease (COPD). Which observation(s) by the nurse require immediate intervention to reduce the likelihood of harm to this client? (Select all that apply.).

A nurse is caring for a client who has Alzheimer's disease.Which of the following findings should the nurse expect?

A parent asked the nurse how to care for their 4-year-old child after receiving the Haemophilus influenzae Type b (Hib) conjugate vaccine.Which instruction should the nurse provide?

A nurse is teaching a client who has a fungal infection about fluconazole.Which of the following statements by the client indicates an understanding of the teaching?

A woman at 12 weeks' gestation comes to the clinic for her first prenatal visit. After completing a health history, the nurse should discuss which topic of pregnancy at this initial visit.

While changing a client's postoperative dressing, the nurse observes purulent drainage at the site.Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

An older client with dementia who is refusing to allow an unlicensed assistive personnel (UAP) bathe her is becoming increasingly agitated and stating the UAP wants to hurt her and tie her up. Which approach should the nurse use with the client?

A client who weighs 176 pounds receives a prescription for norepinephrine 2 mcg/min intravenously (IV). The IV bag is labeled, "Norepinephrine 4 mg in dextrose 5% in water (D; W) 1,000 mL." How many mL/hour should the nurse program the infusion pump? (Enter numerical value only.).