Nursing Elites

1. How should a caregiver manage a child with a newly diagnosed hearing impairment?

• A. Increase the volume of all auditory stimuli
• B. Refer for audiologic evaluation and intervention
• C. Avoid using any assistive devices
• D. Encourage frequent use of headphones

Correct answer: B

Rationale: When a child is newly diagnosed with a hearing impairment, it is essential to refer them for audiologic evaluation and intervention. This step is crucial to accurately assess the extent of the impairment, determine appropriate interventions, and support the child's communication and development. Increasing the volume of all auditory stimuli (choice A) is not a recommended approach as it may not address the specific needs of the child and could potentially cause discomfort. Avoiding the use of assistive devices (choice C) can hinder the child's ability to communicate effectively. Encouraging frequent use of headphones (choice D) is also not advisable as it may not be suitable for managing hearing impairments and could potentially worsen the condition.

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 the most effective therapy for maintaining remission of acute lymphoblastic leukemia?

• A. Surgery to remove enlarged lymph nodes
• B. Long-term chemotherapy
• C. Nutritional supplements to enhance blood cell production
• D. Blood transfusions to replace ineffective red cells

Correct answer: B

Rationale: The correct answer is B: Long-term chemotherapy. Long-term chemotherapy, specifically with methotrexate, is the most effective therapy for maintaining remission in acute lymphoblastic leukemia. Surgery to remove enlarged lymph nodes (Choice A) is not the primary treatment for leukemia. Nutritional supplements (Choice C) may support overall health but are not the mainstay therapy for maintaining leukemia remission. Blood transfusions (Choice D) are used to address anemia in some cases but are not the primary treatment for maintaining remission in acute lymphoblastic leukemia.

4. What is a common sign of hypothyroidism in children?

• A. Weight loss
• B. Increased heart rate
• C. Dry skin and constipation
• D. Elevated blood pressure

Correct answer: C

Rationale: Dry skin and constipation are typical signs of hypothyroidism in children. Hypothyroidism results from an underactive thyroid gland, leading to symptoms such as dry skin and constipation. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the thyroid gland is overactive. Increased heart rate (Choice B) and elevated blood pressure (Choice D) are also more characteristic of hyperthyroidism rather than hypothyroidism. Therefore, the correct answer is dry skin and constipation (Choice C) when identifying signs of hypothyroidism in children.

5. What intervention is recommended for a child with severe dehydration?

• A. Oral rehydration therapy
• B. Intravenous fluid replacement
• C. High-protein diet
• D. Increased physical activity

Correct answer: B

Rationale: Intravenous fluid replacement is the recommended intervention for a child with severe dehydration because it allows for rapid restoration of fluid and electrolyte balance. In severe cases, oral rehydration therapy (Choice A) may not be tolerated due to the child's condition. A high-protein diet (Choice C) is not the primary intervention and does not address the immediate fluid and electrolyte imbalance. Increased physical activity (Choice D) is contraindicated in severe dehydration as it can exacerbate fluid loss, making intravenous fluid replacement the most suitable choice for prompt correction of the severe dehydration.

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