Nursing Elites

1. Adoley has been presented at the OPD with the following clinical manifestations: crying easily, short attention span, inability to sit still, fatigue but unable to sleep at night, excessive sweating, increased heart rate, and blood pressure. Which of the following will be the appropriate diagnosis for Adoley?

• A. Autism
• B. Hyperthyroidism
• C. Hypoglycemia
• D. Pneumonia

Correct answer: B

Rationale: The symptoms described in the case, such as excessive sweating, increased heart rate, and inability to sleep, are indicative of hyperthyroidism. Hyperthyroidism is characterized by an overactive thyroid gland, leading to symptoms like increased heart rate, sweating, and difficulty sleeping, which align with Adoley's clinical manifestations. Therefore, the appropriate diagnosis for Adoley would be hyperthyroidism.

2. A child of 3 years has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, he gave a final diagnosis of lower respiratory infection. Which of the following signs will confirm the diagnosis?

• A. Cough
• B. Fever
• C. Inability to lie supine
• D. Inability to eat

Correct answer: C

Rationale: Inability to lie supine is a specific sign of lower respiratory infection. This condition can cause discomfort or difficulty in breathing when lying flat, leading to a preference for an upright or semi-upright position. While cough and fever are common symptoms of respiratory infections, the inability to lie supine is more indicative of lower respiratory involvement.

3. 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.'

4. Which of the following signs is MOST indicative of inadequate breathing in an infant?

• A. Sunken fontanelles
• B. Heart rate of 130 beats/min
• C. Expiratory grunting
• D. Abdominal breathing

Correct answer: C

Rationale: Expiratory grunting is a significant sign of inadequate breathing and respiratory distress in infants. It indicates that the infant is struggling to exhale properly, which can be a sign of various respiratory issues, including lung problems or airway obstruction. Monitoring and recognizing this sign promptly can help in providing timely interventions to support the infant's breathing and prevent further complications.

5. When assessing a 5-year-old boy with major trauma, his blood pressure is 70/40 mm Hg, and his pulse rate is 140 beats/min and weak. The child's blood pressure:

• A. indicates decompensated shock.
• B. reflects adequate compensation.
• C. suggests increased intracranial pressure.
• D. is appropriate based on his age.

Correct answer: A

Rationale: In a 5-year-old boy with major trauma, a blood pressure of 70/40 mm Hg and a pulse rate of 140 beats/min, and weak, indicate decompensated shock. This presentation signifies inadequate perfusion, leading to compensatory mechanisms being overwhelmed, resulting in decompensated shock. Choice B is incorrect as the vital signs suggest the body is unable to adequately compensate for the trauma. Choice C is incorrect as the vital signs are more indicative of shock rather than increased intracranial pressure. Choice D is incorrect as such low blood pressure is not appropriate for a child of this age and indicates a critical condition.

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