Nursing Elites

1. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

• A. Give the child honey (simple sugar)
• B. Give the child milk (complex sugar)
• C. Contact the healthcare provider before doing anything
• D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

2. How would you classify a child at two years of age who has fast breathing without chest indrawing or stridor when calm?

• A. Very severe disease
• B. Pneumonia
• C. No pneumonia
• D. Local infection

Correct answer: B

Rationale: In pediatric clinical assessment, a child at two years of age with fast breathing but without chest indrawing or stridor when calm is classified as having pneumonia. Fast breathing in this context is a key symptom used in the Integrated Management of Childhood Illness (IMCI) guidelines to diagnose pneumonia in children under five years old. The absence of chest indrawing or stridor when the child is calm helps differentiate this case from other respiratory conditions, making pneumonia the likely classification. Choices A, C, and D are incorrect. 'Very severe disease' is too broad and not specific to the symptoms described. 'No pneumonia' is also incorrect as the symptoms match the presentation of pneumonia. 'Local infection' is too vague and does not specifically address the respiratory symptoms observed.

3. A 3-year-old child has been admitted to your pediatric ward. The doctor gave a provisional diagnosis of respiratory tract infection. After careful assessment and history, a final diagnosis of lower respiratory infection was made. 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 characteristic sign of lower respiratory infection. This positioning preference is often seen in patients with lower respiratory infections due to discomfort or difficulty breathing when lying flat on their back. While cough and fever are common symptoms associated with respiratory infections, they are not specific to lower respiratory infections. Inability to eat may indicate general illness or discomfort but is not a specific indicator of lower respiratory infection.

4. When managing Akosua Adepa, an eight-year-old diagnosed with Asthma, the nurse will consider the following as complications EXCEPT:

• A. Cor pulmonale
• B. Respiratory arrest
• C. Respiratory distress
• D. Respiratory failure

Correct answer: C

Rationale: When managing a pediatric patient with asthma, the nurse needs to be vigilant about potential complications. While cor pulmonale, respiratory arrest, and respiratory failure are known complications of asthma, respiratory distress is not typically considered a direct complication. Respiratory distress is more of a symptom or a sign of worsening asthma, indicating the need for immediate intervention to prevent progression to more severe complications.

5. 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.

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