NRNP 6541 TEST BANK 2026/2027 LATEST SPRING
SUMMER ACTUAL EXAM ACTUAL EXAM Complete
Verified Questions And Correct Detailed Answers|
GUARANTEED PASS Graded A+
Supplemental oxygen via the blow-by technique is MOST appropriate for a child who presents with
respiratory difficulty and:
• A:is agitated, tachycardic, and clinging to his or her parent.
• B:has a heart rate of 70 beats/min and signs of physical exhaustion.
• C:is breathing with a significant reduction in tidal volume.
• D:has facial cyanosis and a decreased level of consciousness. You selected A; This is correct!
Reason:If a child presents with respiratory difficulty, the method of oxygen delivery depends on his or
her mental status, respiratory effort, and heart rate. A child with respiratory distress has an increased
work of breathing, is agitated and tachycardic, and is clinging to his or her parent. Oxygen for a child
with respiratory distress should be given by the least threatening method. You should avoid further
agitation of the child, which may cause deterioration of his or her condition. Give the child oxygen via
the blow-by technique; allow the parent to hold the mask or oxygen tubing near the child's face. By
contrast, respiratory failure in the child is characterized by a decreased level of consciousness, signs of
physical exhaustion, reduced tidal volume (shallow breathing), cyanosis, and bradycardia. Children with
respiratory failure need assisted ventilation with a bag-mask device and high-flow oxygen. Remember,
respiratory failure is the most common cause of cardiac arrest in infants and children
After the baby's head delivers, it is usually tilted:
• A:anteriorly, with the chin up.
• B:with the face up.
• C:posteriorly, to one side.
• D:posteriorly, face down. The correct answer is C;
Reason:As the baby's head begins to deliver, it is usually in a posterior, face down position. After the
head delivers completely, however, it usually tilts to the side in preparation for delivery of the
shoulders. Remember to check for the presence of a nuchal cord (umbilical cord wrapped around the
neck), and to suction the baby's mouth and nose as soon as its head delivers.
A 6-year-old boy complains of pain to the right lower quadrant of his abdomen. Assessment of this
child's abdomen should include:
1
,• A:palpating the right lower quadrant first.
• B:auscultating bowel sounds for 2 minutes.
• C:avoiding palpation of the abdomen.
• D:palpating the left upper quadrant first. You selected D; This is correct!
Reason: When assessing the abdomen of any patient, you should determine the location of the pain and
palpate that area last. Begin by palpating the abdomen furthest away from the area of pain; in this case,
the left upper quadrant is furthest away from the right lower quadrant. Palpating the painful area first
will interfere with the rest of your assessment because the patient will be in significant pain and will
likely not remain still during the remainder of the assessment. This is especially true in children.
Auscultation of bowel sounds is generally not performed in the prehospital setting; little, if any,
information will be gained from doing so.
Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress,
a strong cough, and normal skin color, includes:
• A:oxygen, back slaps, and transport.
• B:assisted ventilations, back slaps, and transport.
• C:subdiaphragmatic thrusts until the object is expelled.
• D:supplemental oxygen and transport.
The correct answer is D;
Reason:If a child (1 year of age to the onset of puberty [12 to 14 years of age]) with a mild airway
obstruction is alert and has adequate air movement (ie, a strong cough, normal skin color), you should
offer oxygen, avoid agitating the child, and provide transport to the hospital. Attempts to relieve a mild
airway obstruction may result in a severe airway obstruction. If signs of a severe airway obstruction
develop, you must take immediate action to remove the object (eg, back slaps and chest thrusts in a
responsive infant; subdiaphragmatic [abdominal] thrusts in a responsive adult or child). Finger sweeps
are ONLY indicated if the patient is unresponsive and you can see the object in his or her mouth.
When is it MOST appropriate to clamp and cut the umbilical cord?
• A:As soon as the cord has stopped pulsating
• B:Immediately following delivery of the newborn
• C:Before the newborn has taken its first breath
• D:After the placenta has completely delivered
You selected A; This is correct!
2
,Reason: Generally, it is safe to clamp and cut the umbilical cord once it has stopped pulsating and the
baby is breathing adequately. When blood flow through the umbilical cord ceases, it will stop pulsating;
this indicates that the baby is oxygenating its own blood. If the cord does not stop pulsating and/or the
baby is not breathing adequately, the cord should not be clamped and cut and the baby should be kept
at the level of the mother's perineum and managed appropriately while en route to the hospital.
After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a
shock advised message. After delivering the shock, you should:
• A:reanalyze the cardiac rhythm.
• B:immediately perform CPR.
• C:assess for a carotid pulse.
• D:open the airway and ventilate. You selected B; This is correct!
Reason: After the AED delivers a shock, you should immediately begin or resume CPR, starting with
chest compressions. Perform CPR for 2 minutes and then reanalyze the child's cardiac rhythm. If the AED
states that a shock is advised, defibrillate without delay and then continue CPR. If the AED states no
shock advised, resume CPR and reassess in 2 minutes. Do not check for a pulse after defibrillation or if
the AED gives a no shock message; this only causes an unecessary delay in performing chest
compressions. Continue CPR and cardiac rhythm analysis and defibrillation (if indicated) every 2 minutes
until ALS personnel arrive or the patient starts to move spontaneously.
Prevention of cardiac arrest in infants and small children should focus primarily on:
• A:providing immediate transport.
• B:avoiding upsetting the child.
• C:ensuring adequate ventilation.
• D:keeping the child warm. You selected C; This is correct!
Reason:The most common cause of cardiac arrest in infants and children is failure of the respiratory
system. Their hearts generally are healthy, and they rarely go into ventricular fibrillation (V-Fib). The key
to preventing cardiac arrest in the majority of infants and children is to ensure adequate ventilation and
oxygenation.
A 29-year-old woman, who is 38 weeks pregnant, presents with heavy vaginal bleeding, a blood pressure
of 70/50 mm Hg, and a heart rate of 130 beats/min. She is pale and diaphoretic, and denies abdominal
cramping or pain. Her signs and symptoms are MOST consistent with a/an:
• A:placenta previa.
3
, • B:abruptio placenta.
• C:ruptured ectopic pregnancy.
• D:ruptured ovarian cyst. The correct answer is A;
Reason:Of the conditions listed, placenta previa would be the least likely to present with abdominal
pain, although some patients may have pain or cramping. Placenta previa is a condition in which the
placenta develops over and covers some or all of the cervix. As the cervix dilates, the vasculature that
attaches the placenta to the uterine wall tears, resulting in vaginal bleeding that is often severe enough
to cause shock. By contrast, abruptio placenta is a condition in which the placenta prematurely
separates from the uterine wall; it is characterized by tearing abdominal pain, heavy vaginal bleeding,
and shock. Placenta previa and abruptio placenta occur during the later stages of pregnancy. A ruptured
ovarian cyst typically causes lower abdominal pain, often unilateral. Ectopic pregnancy, a condition in
which the egg implants and grows outside the uterus (usually in a fallopian tube), is a first trimester
condition; it is typically discovered between 8 and 10 weeks of pregnancy. If the ectopic pregnancy
ruptures, the patient often presents with a sudden stabbing pain in the lower abdomen and shock due
to intraabdominal hemorrhage.
Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-
old child?
• A:Skin color and temperature
• B:Presence of peripheral pulses
• C:Systolic blood pressure
• D:Capillary refill time You selected C; This is correct!
Reason:You should never rely on the systolic blood pressure when assessing the perfusion status of
anyone. More reliable parameters include assessing peripheral pulses, capillary refill time (most reliable
in children younger than 6 years of age), and the condition and temperature of the skin. Remember that
the body's compensatory mechanisms work to maintain the blood pressure, so when it falls, this
corresponds to decompensated shock.
You are responding to a call for a 2-year-old child who fell from a second-story window. With the
mechanism of injury and the age of the patient in mind, you should suspect that the primary injury
occurred to the child's:
• A:head.
• B:lower extremities.
• C:abdomen.
• D:chest. You selected A; This is correct!
4
SUMMER ACTUAL EXAM ACTUAL EXAM Complete
Verified Questions And Correct Detailed Answers|
GUARANTEED PASS Graded A+
Supplemental oxygen via the blow-by technique is MOST appropriate for a child who presents with
respiratory difficulty and:
• A:is agitated, tachycardic, and clinging to his or her parent.
• B:has a heart rate of 70 beats/min and signs of physical exhaustion.
• C:is breathing with a significant reduction in tidal volume.
• D:has facial cyanosis and a decreased level of consciousness. You selected A; This is correct!
Reason:If a child presents with respiratory difficulty, the method of oxygen delivery depends on his or
her mental status, respiratory effort, and heart rate. A child with respiratory distress has an increased
work of breathing, is agitated and tachycardic, and is clinging to his or her parent. Oxygen for a child
with respiratory distress should be given by the least threatening method. You should avoid further
agitation of the child, which may cause deterioration of his or her condition. Give the child oxygen via
the blow-by technique; allow the parent to hold the mask or oxygen tubing near the child's face. By
contrast, respiratory failure in the child is characterized by a decreased level of consciousness, signs of
physical exhaustion, reduced tidal volume (shallow breathing), cyanosis, and bradycardia. Children with
respiratory failure need assisted ventilation with a bag-mask device and high-flow oxygen. Remember,
respiratory failure is the most common cause of cardiac arrest in infants and children
After the baby's head delivers, it is usually tilted:
• A:anteriorly, with the chin up.
• B:with the face up.
• C:posteriorly, to one side.
• D:posteriorly, face down. The correct answer is C;
Reason:As the baby's head begins to deliver, it is usually in a posterior, face down position. After the
head delivers completely, however, it usually tilts to the side in preparation for delivery of the
shoulders. Remember to check for the presence of a nuchal cord (umbilical cord wrapped around the
neck), and to suction the baby's mouth and nose as soon as its head delivers.
A 6-year-old boy complains of pain to the right lower quadrant of his abdomen. Assessment of this
child's abdomen should include:
1
,• A:palpating the right lower quadrant first.
• B:auscultating bowel sounds for 2 minutes.
• C:avoiding palpation of the abdomen.
• D:palpating the left upper quadrant first. You selected D; This is correct!
Reason: When assessing the abdomen of any patient, you should determine the location of the pain and
palpate that area last. Begin by palpating the abdomen furthest away from the area of pain; in this case,
the left upper quadrant is furthest away from the right lower quadrant. Palpating the painful area first
will interfere with the rest of your assessment because the patient will be in significant pain and will
likely not remain still during the remainder of the assessment. This is especially true in children.
Auscultation of bowel sounds is generally not performed in the prehospital setting; little, if any,
information will be gained from doing so.
Treatment for a responsive 4-year-old child with a mild airway obstruction, who has respiratory distress,
a strong cough, and normal skin color, includes:
• A:oxygen, back slaps, and transport.
• B:assisted ventilations, back slaps, and transport.
• C:subdiaphragmatic thrusts until the object is expelled.
• D:supplemental oxygen and transport.
The correct answer is D;
Reason:If a child (1 year of age to the onset of puberty [12 to 14 years of age]) with a mild airway
obstruction is alert and has adequate air movement (ie, a strong cough, normal skin color), you should
offer oxygen, avoid agitating the child, and provide transport to the hospital. Attempts to relieve a mild
airway obstruction may result in a severe airway obstruction. If signs of a severe airway obstruction
develop, you must take immediate action to remove the object (eg, back slaps and chest thrusts in a
responsive infant; subdiaphragmatic [abdominal] thrusts in a responsive adult or child). Finger sweeps
are ONLY indicated if the patient is unresponsive and you can see the object in his or her mouth.
When is it MOST appropriate to clamp and cut the umbilical cord?
• A:As soon as the cord has stopped pulsating
• B:Immediately following delivery of the newborn
• C:Before the newborn has taken its first breath
• D:After the placenta has completely delivered
You selected A; This is correct!
2
,Reason: Generally, it is safe to clamp and cut the umbilical cord once it has stopped pulsating and the
baby is breathing adequately. When blood flow through the umbilical cord ceases, it will stop pulsating;
this indicates that the baby is oxygenating its own blood. If the cord does not stop pulsating and/or the
baby is not breathing adequately, the cord should not be clamped and cut and the baby should be kept
at the level of the mother's perineum and managed appropriately while en route to the hospital.
After attaching the AED to a 7-year-old child in cardiac arrest, you push the analyze button and receive a
shock advised message. After delivering the shock, you should:
• A:reanalyze the cardiac rhythm.
• B:immediately perform CPR.
• C:assess for a carotid pulse.
• D:open the airway and ventilate. You selected B; This is correct!
Reason: After the AED delivers a shock, you should immediately begin or resume CPR, starting with
chest compressions. Perform CPR for 2 minutes and then reanalyze the child's cardiac rhythm. If the AED
states that a shock is advised, defibrillate without delay and then continue CPR. If the AED states no
shock advised, resume CPR and reassess in 2 minutes. Do not check for a pulse after defibrillation or if
the AED gives a no shock message; this only causes an unecessary delay in performing chest
compressions. Continue CPR and cardiac rhythm analysis and defibrillation (if indicated) every 2 minutes
until ALS personnel arrive or the patient starts to move spontaneously.
Prevention of cardiac arrest in infants and small children should focus primarily on:
• A:providing immediate transport.
• B:avoiding upsetting the child.
• C:ensuring adequate ventilation.
• D:keeping the child warm. You selected C; This is correct!
Reason:The most common cause of cardiac arrest in infants and children is failure of the respiratory
system. Their hearts generally are healthy, and they rarely go into ventricular fibrillation (V-Fib). The key
to preventing cardiac arrest in the majority of infants and children is to ensure adequate ventilation and
oxygenation.
A 29-year-old woman, who is 38 weeks pregnant, presents with heavy vaginal bleeding, a blood pressure
of 70/50 mm Hg, and a heart rate of 130 beats/min. She is pale and diaphoretic, and denies abdominal
cramping or pain. Her signs and symptoms are MOST consistent with a/an:
• A:placenta previa.
3
, • B:abruptio placenta.
• C:ruptured ectopic pregnancy.
• D:ruptured ovarian cyst. The correct answer is A;
Reason:Of the conditions listed, placenta previa would be the least likely to present with abdominal
pain, although some patients may have pain or cramping. Placenta previa is a condition in which the
placenta develops over and covers some or all of the cervix. As the cervix dilates, the vasculature that
attaches the placenta to the uterine wall tears, resulting in vaginal bleeding that is often severe enough
to cause shock. By contrast, abruptio placenta is a condition in which the placenta prematurely
separates from the uterine wall; it is characterized by tearing abdominal pain, heavy vaginal bleeding,
and shock. Placenta previa and abruptio placenta occur during the later stages of pregnancy. A ruptured
ovarian cyst typically causes lower abdominal pain, often unilateral. Ectopic pregnancy, a condition in
which the egg implants and grows outside the uterus (usually in a fallopian tube), is a first trimester
condition; it is typically discovered between 8 and 10 weeks of pregnancy. If the ectopic pregnancy
ruptures, the patient often presents with a sudden stabbing pain in the lower abdomen and shock due
to intraabdominal hemorrhage.
Which of the following parameters is the LEAST reliable when assessing the perfusion status of a 2-year-
old child?
• A:Skin color and temperature
• B:Presence of peripheral pulses
• C:Systolic blood pressure
• D:Capillary refill time You selected C; This is correct!
Reason:You should never rely on the systolic blood pressure when assessing the perfusion status of
anyone. More reliable parameters include assessing peripheral pulses, capillary refill time (most reliable
in children younger than 6 years of age), and the condition and temperature of the skin. Remember that
the body's compensatory mechanisms work to maintain the blood pressure, so when it falls, this
corresponds to decompensated shock.
You are responding to a call for a 2-year-old child who fell from a second-story window. With the
mechanism of injury and the age of the patient in mind, you should suspect that the primary injury
occurred to the child's:
• A:head.
• B:lower extremities.
• C:abdomen.
• D:chest. You selected A; This is correct!
4
