Nursing Elites

1. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

• A. The child should be allowed to play because doing so can foster healthy self-esteem
• B. The risk for fractures is increased because GH deficiency results in fragile bones
• C. Activity could aggravate insulin sensitivity, causing hyperglycemia
• D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

2. 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.

3. To prevent diarrhea in children, a vaccine is available against which of the following?

• A. Adenovirus
• B. Rotavirus
• C. Enterovirus
• D. All of the above

Correct answer: B

Rationale: The correct answer is B - Rotavirus. Rotavirus vaccine is available to prevent diarrhea in children. Rotavirus is a common cause of severe diarrhea in infants and young children globally, and vaccination has been shown to be effective in reducing the burden of this disease. Choices A and C are incorrect because there is no specific vaccine available for Adenovirus or Enterovirus to prevent diarrhea in children. Choice D is incorrect because while vaccines are available for some viruses that can cause diarrhea in children, not all mentioned in the choices have a specific vaccine available.

4. The nurse is assessing a postpartum client's fundus. Where should the nurse expect to find the fundus 24 hours after delivery?

• A. At the level of the umbilicus
• B. 1 cm above the symphysis pubis
• C. At the level of the xiphoid process
• D. 2 cm below the umbilicus

Correct answer: A

Rationale: After delivery, the fundus is expected to be at the level of the umbilicus 24 hours postpartum. This position indicates that the uterus is involuting properly. Assessing the fundal height helps monitor the progress of uterine involution and can identify any potential complications like postpartum hemorrhage.

5. Madam Serwaa's 7-month-old baby was admitted to your ward with malnutrition. The child has diarrhea with signs of moderate dehydration but can drink. Which of the following will be the most appropriate fluid for Madam Serwaa's baby?

• A. ORS
• B. Resomal
• C. Rice water
• D. I.V. Ringer's lactate

Correct answer: A

Rationale: For a 7-month-old baby with diarrhea and signs of moderate dehydration who can still drink, the most appropriate fluid is Oral Rehydration Solution (ORS). ORS helps in rehydrating the body and replenishing lost electrolytes, making it essential in managing dehydration due to diarrhea.

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