Nursing Elites

1. What is the term for a condition where there is a failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children, with 80% of cases being idiopathic? It may present with familial patterns, affecting males more than females.

• A. Cretinism
• B. Growth hormone deficiency
• C. Hypothyroidism
• D. Precocious puberty

Correct answer: B

Rationale: Growth hormone deficiency refers to a condition where there is inadequate production of growth hormone by the pituitary gland. This results in impaired growth in children. While 80% of cases are of unknown cause (idiopathic), some may have familial patterns. It is more common in males than females. Cretinism is a condition of severe hypothyroidism during infancy, not related to growth hormone. Hypothyroidism is a disorder involving low thyroid hormone levels, and precocious puberty is the early onset of puberty. Therefore, the correct answer is 'Growth hormone deficiency.'

2. When educating the mother of a child with respiratory disease who needs a lot of fluids, the mother tells the nurse that when she offers her 24-month-old son juice, he always shakes his head and says, 'No'. The nurse suggests that the mother:

• A. Be firm and hand him the glass
• B. Distract him with some food
• C. Let him see that he is making her angry
• D. Offer him a choice of two things to drink

Correct answer: D

Rationale: Offering a choice can help the child feel more in control and willing to drink. By providing the child with options, the mother empowers him to make a decision, which can increase his willingness to drink fluids. This approach promotes a sense of autonomy and may lead to a more positive response from the child, ultimately contributing to better fluid intake, especially important for a child with a respiratory disease.

3. What intervention should the nurse encourage for a postpartum client complaining of perineal pain?

• A. Use of ice packs for the first 24 hours
• B. Application of heat packs immediately
• C. Avoiding the use of peri-bottles
• D. Using tampons to manage lochia

Correct answer: A

Rationale: The correct intervention for perineal pain in a postpartum client is the use of ice packs for the first 24 hours. Ice packs help reduce swelling and discomfort in the perineal area, especially during the initial post-delivery period. Applying heat packs can exacerbate swelling and discomfort. Avoiding peri-bottles may lead to poor perineal hygiene. Using tampons is contraindicated postpartum as it increases the risk of infection.

4. A mother of a 6-year-old actively playing child, diagnosed with type 1 diabetes mellitus a year ago, calls a clinic nurse and reports that the child has been sick. She checked the child's urine, which was positive for ketones. What should the nurse instruct the mother to do?

• A. Administer an additional dose of regular insulin
• B. Come to the clinic immediately
• C. Encourage the child to drink liquids
• D. Hold the next dose of insulin

Correct answer: C

Rationale: Encouraging the child to drink liquids is essential in managing ketones in urine. Increased fluid intake can help prevent dehydration and aid in flushing out ketones, which is crucial in managing diabetic ketoacidosis, a serious complication of uncontrolled diabetes.

5. The healthcare provider is preparing to administer Rh immune globulin (RhoGAM) to a postpartum client. This medication is indicated for:

• A. Rh-negative individuals with Rh-positive infants
• B. Rh-positive individuals with Rh-negative infants
• C. All individuals regardless of Rh status
• D. Individuals with a history of Rh incompatibility

Correct answer: A

Rationale: Rh immune globulin (RhoGAM) is administered to Rh-negative individuals who have given birth to Rh-positive infants to prevent Rh sensitization. When an Rh-negative individual gives birth to an Rh-positive infant, there is a risk of the mother developing antibodies against the Rh-positive blood cells, which can lead to hemolytic disease of the newborn in subsequent pregnancies. Rh immune globulin is given to prevent this sensitization in Rh-negative individuals who deliver Rh-positive infants.

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