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. You are dispatched to a residence for a child with respiratory distress. The child is wheezing and has nasal flaring and retractions. His oxygen saturation is 92%. You should:

• A. place the child in a supine position.
• B. administer high-flow oxygen.
• C. begin chest compressions.
• D. administer low-flow oxygen.

Correct answer: B

Rationale: In a scenario where a child presents with respiratory distress, wheezing, nasal flaring, retractions, and an oxygen saturation of 92%, the appropriate intervention is to administer high-flow oxygen. This helps to improve oxygenation and alleviate the respiratory distress the child is experiencing. Placing the child in a supine position can worsen their condition by affecting their ability to breathe effectively. Chest compressions are not indicated in this case as the child is not in cardiac arrest. Administering low-flow oxygen may not provide adequate oxygenation for a child in respiratory distress with a saturation of 92%. Therefore, the priority is to administer high-flow oxygen to improve oxygen levels and support the child's breathing.

3. What is the most appropriate action to prevent heat loss in a newborn immediately after birth?

• A. Place the newborn in an incubator
• B. Bathe the newborn right away
• C. Dry the newborn thoroughly
• D. Feed the newborn

Correct answer: C

Rationale: Drying the newborn thoroughly is the most appropriate action to prevent heat loss immediately after birth. This helps to prevent heat loss through evaporation, which is crucial in maintaining the newborn's body temperature. Placing the newborn in an incubator can be a secondary step after ensuring the baby is dry. Bathing the newborn right away is not recommended as it can lead to further heat loss through evaporation. Feeding the newborn is important but not an immediate action to prevent heat loss; ensuring the baby is dry and warm takes precedence.

4. How can a new mother tell if her baby is getting enough breast milk?

• A. If your baby sleeps through the night, they are getting enough milk.
• B. If your baby has six to eight wet diapers a day, they are getting enough milk.
• C. If your baby cries frequently, they are getting enough milk.
• D. If your baby is awake and alert, they are getting enough milk.

Correct answer: B

Rationale: The correct answer is B. If a new mother observes that her baby has six to eight wet diapers a day, it indicates that the baby is getting enough breast milk. This is a crucial indicator of adequate milk intake and hydration in infants. Conversely, choices A, C, and D are incorrect. A baby sleeping through the night, crying frequently, or being awake and alert are not reliable indicators of sufficient breast milk intake. It is essential for new mothers to track their baby's diaper output to ensure they are receiving the necessary nutrition.

5. In counseling the parents of a child with hypopituitarism, Nurse Gyimah is asked about their child's condition. Which of the following phrases, if stated by the nurse, best describes the condition?

• A. Linear growth retardation with skeletal proportions normal for chronologic age
• B. A complete normal growth pattern, but with the onset of precocious puberty
• C. Normal growth for the first five years, followed by progressive linear growth retardation
• D. Growth retardation in which height and weight are equally affected

Correct answer: A

Rationale: Hypopituitarism is characterized by linear growth retardation with skeletal proportions normal for chronologic age. This means that although the child experiences growth retardation, their skeletal proportions are appropriate for their age, which distinguishes it from other conditions like precocious puberty or equal height and weight affectation. Choice B is incorrect as hypopituitarism does not involve precocious puberty. Choice C is wrong as it describes a different growth pattern not typical of hypopituitarism. Choice D is also incorrect as in hypopituitarism, height and weight are not equally affected, rather the focus is on linear growth retardation with normal skeletal proportions.

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