Nursing Elites

1. How should the healthcare provider respond to a parent concerned about a child's short stature?

• A. Suggest the parent consult a nutritionist
• B. Recommend frequent growth hormone injections
• C. Advise monitoring for a few years before intervention
• D. Refer for a genetic evaluation

Correct answer: C

Rationale: When a parent expresses concern about a child's short stature, the initial approach should involve advising monitoring for a few years before considering any interventions. This allows for observation of the child's growth pattern and any potential underlying issues. Suggesting a nutritionist (Choice A) may not be necessary if there are no signs of nutritional deficiencies. Recommending growth hormone injections (Choice B) is premature without proper evaluation and diagnosis. Referring for a genetic evaluation (Choice D) can be considered later if monitoring shows atypical growth patterns or other concerning factors.

2. What is an important consideration when administering medications to a child with hepatic dysfunction?

• A. Increased dosing intervals
• B. Adjustments in dosage due to altered metabolism
• C. Avoid all medications
• D. Use only topical medications

Correct answer: B

Rationale: When administering medications to a child with hepatic dysfunction, it is crucial to make adjustments in dosage due to altered metabolism. Hepatic dysfunction can affect the way medications are metabolized in the body, potentially leading to drug toxicity or reduced effectiveness. This is why adjusting the dosage is essential to ensure the medication is both safe and efficient. Choices A, C, and D are incorrect because increasing dosing intervals, avoiding all medications, or using only topical medications do not address the specific issue of altered drug metabolism in hepatic dysfunction.

3. 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.

4. What is a key intervention for a child with a new diagnosis of type 1 diabetes?

• A. Insulin administration
• B. Increased dietary fat intake
• C. Restricted fluid intake
• D. Routine physical examinations only

Correct answer: A

Rationale: The correct answer is A: Insulin administration. When a child is diagnosed with type 1 diabetes, insulin administration is a crucial intervention. Insulin helps regulate blood glucose levels by enabling cells to take in glucose from the bloodstream. Without sufficient insulin, blood glucose levels can become dangerously high, leading to various complications. Increased dietary fat intake (choice B) is not a recommended intervention for type 1 diabetes management, as it can contribute to weight gain and other health issues. Restricted fluid intake (choice C) is also not appropriate, as adequate hydration is essential for overall health. Routine physical examinations (choice D) are important but are not the primary intervention needed to manage type 1 diabetes.

5. What should be assessed in a child with suspected appendicitis?

• A. Level of consciousness
• B. Bowel sounds and pain location
• C. Skin color and temperature
• D. Heart rate and blood pressure

Correct answer: B

Rationale: The correct answer is to assess bowel sounds and pain location. In a child with suspected appendicitis, focusing on bowel sounds and pain location, particularly in the lower right quadrant, is crucial. This assessment helps to identify symptoms commonly associated with appendicitis. Assessing the level of consciousness (Choice A) is important in other conditions such as head injuries or neurological issues. Skin color and temperature (Choice C) are more indicative of circulatory or skin-related problems. Heart rate and blood pressure (Choice D) are vital signs that are essential to assess in various conditions but are not specific to suspected appendicitis.

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