Nursing Elites

1. What action should be taken for a 2-year-old with laryngotracheobronchitis in an oxygen tent?

• A. Restrain the child and notify the healthcare provider
• B. Increase the oxygen concentration
• C. Take the child to the playroom
• D. Ask the mother to help in comforting the child

Correct answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

2. What is a causative factor of Hirschsprung disease?

• A. Frequent evacuation of solids, liquids, and gases
• B. Excessive peristaltic movement
• C. Absence of parasympathetic ganglion cells in a portion of the colon
• D. One portion of the bowel telescoping into another

Correct answer: C

Rationale: The correct answer is C: Absence of parasympathetic ganglion cells in a portion of the colon. Hirschsprung disease is a congenital condition characterized by the absence of nerve cells (ganglia) in parts of the colon. This absence leads to a lack of peristalsis in the affected segment, resulting in severe constipation and bowel obstruction. Choices A, B, and D are incorrect. Choice A describes symptoms of diarrhea rather than a causative factor of Hirschsprung disease. Excessive peristaltic movement (choice B) is not a causative factor but rather the opposite, as Hirschsprung disease is associated with reduced peristalsis. Choice D, which refers to intussusception, is a different condition unrelated to Hirschsprung disease.

3. What is the recommended first step in the management of a child with a suspected head injury?

• A. Administer pain medication
• B. Assess the child's level of consciousness
• C. Perform a CT scan
• D. Monitor for seizures

Correct answer: B

Rationale: The correct first step in managing a child with a suspected head injury is to assess the child's level of consciousness. This assessment is crucial as it helps determine the severity of the injury and guides further management. Administering pain medication (Choice A) should not be done before assessing the level of consciousness. Performing a CT scan (Choice C) may be necessary but is not the initial step. Monitoring for seizures (Choice D) is important but comes after assessing the child's level of consciousness.

4. What is a common sign of dehydration in a child with diarrhea?

• A. Decreased urine output
• B. Increased appetite
• C. Warm, dry skin
• D. Elevated blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased urine output. When a child with diarrhea is dehydrated, they may have decreased urine output, indicating that their body is conserving fluids. This sign highlights the importance of fluid replacement to prevent worsening dehydration. Choices B, C, and D are incorrect. Increased appetite is not typically associated with dehydration but can be seen in other conditions. Warm, dry skin may be a sign of fever or other skin conditions, not specifically dehydration. Elevated blood pressure is not a common sign of dehydration in a child with diarrhea.

5. How should a healthcare professional respond to a parent concerned about their child's weight gain?

• A. Provide guidance on healthy eating and physical activity
• B. Suggest restrictive dieting
• C. Recommend increased caloric intake
• D. Avoid discussing the issue

Correct answer: A

Rationale: When a parent expresses concern about their child's weight gain, the most appropriate response is to provide guidance on healthy eating and physical activity. This approach promotes healthy weight management and overall well-being. Suggesting restrictive dieting (Choice B) can be harmful, especially for children, as it may lead to unhealthy relationships with food and potential nutritional deficiencies. Recommending increased caloric intake (Choice C) without proper assessment and guidance can exacerbate the issue. Avoiding discussing the issue (Choice D) neglects a critical opportunity to address the parent's concerns and support the child's health.

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