Nursing Elites

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

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

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 child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

3. What clinical manifestation of tetralogy of Fallot should the nurse expect when caring for children with this diagnosis?

• A. Slow respirations
• B. Clubbing of fingers
• C. Decreased RBC counts
• D. Subcutaneous hemorrhages

Correct answer: B

Rationale: Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. Clubbing occurs as a result of long-standing decreased oxygen levels in the blood, leading to changes in the fingertips. Slow respirations (Choice A) are not typically a direct clinical manifestation of tetralogy of Fallot. While decreased RBC counts (Choice C) may occur due to chronic hypoxia, they are not a primary manifestation specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a common clinical manifestation associated with tetralogy of Fallot.

4. A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

• A. Lispro
• B. Regular
• C. NPH
• D. Glargine

Correct answer: D

Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (A) and Regular (B) are rapid-acting insulins with shorter durations of action. NPH (C) is an intermediate-acting insulin with a duration of action of about 12-16 hours. Therefore, Glargine is the correct choice for the insulin with the longest duration.

5. The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

• A. Abdominal swelling
• B. Weight gain
• C. Hypotension
• D. Increased urinary output

Correct answer: A

Rationale: Abdominal swelling is frequently the initial assessment finding associated with a Wilms tumor. This swelling is caused by the tumor's mass in the kidney, leading to abdominal distension. Weight gain (Choice B) is less likely as a primary finding, as it may occur later due to tumor growth or fluid retention. Hypotension (Choice C) is not typically associated with Wilms tumor unless severe complications like hemorrhage develop. Increased urinary output (Choice D) is not a common initial finding; instead, hematuria or other urinary changes may be observed later in the disease process.

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