what finding would the nurse expect to assess in a child with hypothyroidism
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Nursing Elites

HESI LPN

Pediatrics HESI 2023

1. What finding would the nurse expect to assess in a child with hypothyroidism?

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

2. A healthcare professional is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the professional integrates knowledge that bone growth occurs primarily in which area?

Correct answer: B

Rationale: Bone growth primarily occurs in the epiphysis, which is the area where growth plates are located. The epiphysis is responsible for longitudinal bone growth. The growth plate, also known as the physis, is the cartilaginous region in the metaphysis where bone growth occurs. The metaphysis is the area between the epiphysis and diaphysis where bone lengthening occurs, but it is not the primary site of bone growth. Therefore, choices A, C, and D are incorrect.

3. The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator?

Correct answer: B

Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It is a localized tenderness experienced when pressure is applied to a specific area, suggesting a potential fracture. This tenderness is considered more specific to a fracture than other symptoms such as lack of spontaneous movement, bruising, or inability to bear weight. Lack of spontaneous movement and inability to bear weight can be present in various musculoskeletal injuries, while bruising may not always be immediate or specific to a fracture.

4. A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?

Correct answer: A

Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways, making breathing easier and relieving acute symptoms of asthma. Antihistamines are not the first-line treatment for asthma exacerbations; they are more commonly used for allergic reactions. Corticosteroids are beneficial in reducing inflammation in asthma but are usually administered after bronchodilators to provide long-term control. Oxygen therapy may be necessary in severe cases of asthma exacerbation, but bronchodilators take precedence in improving airway patency and respiratory distress.

5. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

Correct answer: B

Rationale: Vomiting and poor appetite are common symptoms of neuroblastoma, a malignancy that arises from neural crest cells in the adrenal glands or sympathetic nervous system. This tumor can cause abdominal swelling due to its location and size, leading to symptoms like vomiting and decreased appetite. The presence of a maculopapular rash on the palms (Choice A) is not a typical finding associated with neuroblastoma. Irritability and failure to thrive (Choice C) are nonspecific symptoms that can be seen in various conditions but are not specifically indicative of neuroblastoma. Auscultation revealing wheezing with diminished lung sounds (Choice D) may suggest respiratory conditions rather than neuroblastoma.

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