Nursing Elites

1. In children with Type 1 diabetes, what is a common early sign of hypoglycemia?

• A. Irritability
• B. Rapid heartbeat
• C. Confusion
• D. Sweating

Correct answer: D

Rationale: Sweating is indeed one of the earliest signs of hypoglycemia in children with Type 1 diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can lead to sweating. While irritability, rapid heartbeat, and confusion can also be seen in hypoglycemia, sweating is particularly common as a quick indicator of low blood sugar levels in children with Type 1 diabetes.

2. What is the primary treatment for Kawasaki disease?

• A. Corticosteroids
• B. Intravenous immunoglobulin
• C. Antibiotics
• D. Antivirals

Correct answer: B

Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.

3. The clinic nurse is teaching parents about when to call the office immediately for a child with a fever. What should the nurse include in the teaching session? (Select all that apply.)

• A. The child has a stiff neck.
• B. The fever is over 40.6 C (105 F).
• C. The child is younger than 2 months.
• D. All of the above

Correct answer: D

Rationale: High fever, especially in very young infants, or the presence of a stiff neck can indicate a serious infection requiring immediate attention. A fever lasting more than 3 days also warrants medical evaluation.

4. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

5. Which pediatric condition is characterized by a "string sign" on an upper GI series?

• A. Intussusception
• B. Hypertrophic pyloric stenosis
• C. Hirschsprung disease
• D. Meckel diverticulum

Correct answer: B

Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.

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