Nursing Elites

1. How should hydration status be assessed in a child with vomiting and diarrhea?

• A. Check skin turgor and mucous membranes
• B. Measure blood glucose levels
• C. Assess heart rate and blood pressure
• D. Evaluate bowel sounds

Correct answer: A

Rationale: Checking skin turgor and mucous membranes is the appropriate method to assess hydration status in a child with vomiting and diarrhea. Skin turgor is an indicator of skin elasticity, which decreases when an individual is dehydrated. Mucous membranes, such as the inside of the mouth, can also show signs of dehydration like dryness. Measuring blood glucose levels (choice B) is not relevant to assessing hydration status in this scenario. Assessing heart rate and blood pressure (choice C) is important in evaluating the overall condition of a child but may not directly indicate hydration status. Evaluating bowel sounds (choice D) is more related to assessing gastrointestinal function rather than hydration status.

2. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

3. What is a common early sign of RSV (respiratory syncytial virus) in infants?

• A. High fever
• B. Nasal congestion
• C. Rash
• D. Jaundice

Correct answer: B

Rationale: Nasal congestion is a common early sign of RSV in infants, often accompanied by cough and wheezing. High fever, rash, and jaundice are not typically associated with RSV. While RSV can lead to fever, it is usually not one of the earliest signs. Rash and jaundice are unrelated to RSV symptoms.

4. The parents of a child with sickle cell anemia ask why their child experiences pain. What is the most likely cause?

• A. Inflammation of the vessels
• B. Obstructed blood flow
• C. Overhydration
• D. Stress-related headaches

Correct answer: B

Rationale: In sickle cell anemia, pain is primarily caused by the obstruction of blood flow by sickle-shaped cells. This obstruction leads to inadequate oxygen supply to tissues, resulting in tissue damage and pain. Choice A, inflammation of the vessels, is incorrect as it is not the primary cause of pain in sickle cell anemia. Choice C, overhydration, is unrelated to the pathophysiology of sickle cell anemia and would not lead to the characteristic pain experienced. Choice D, stress-related headaches, is also unrelated to the underlying mechanisms of pain in sickle cell anemia.

5. Following diarrhea, which foods should be offered to the school-age child?

• A. Apricots and peaches
• B. Chocolate milk
• C. Applesauce and milk
• D. Bananas and rice

Correct answer: D

Rationale: After a bout of diarrhea, it is important to offer foods that are gentle on the stomach and help in recovery. Bananas and rice are commonly recommended as they are easily digestible and can help firm up stools. Apricots, peaches, and applesauce may be too acidic and fibrous, potentially aggravating the stomach. Chocolate milk is high in sugar and can worsen diarrhea due to its lactose content.

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