Nursing Elites

1. 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.

2. How should pain be assessed in a nonverbal child?

• A. Ask the parents about the child’s usual behavior
• B. Observe the child’s facial expressions and body movements
• C. Measure the child’s blood pressure
• D. Use a pain rating scale for older children

Correct answer: B

Rationale: Observing the nonverbal child's facial expressions and body movements is crucial in assessing pain. Nonverbal children may not be able to communicate their discomfort verbally, making it essential to rely on physical cues. Asking parents about the child's usual behavior (choice A) may provide some insight but observing the child directly is more direct and reliable. Measuring blood pressure (choice C) is not typically a direct method for assessing pain in nonverbal children. Using a pain rating scale designed for older children (choice D) is also inappropriate for nonverbal children who cannot participate in such self-reporting tools.

3. What should be monitored closely in a child receiving chemotherapy?

• A. Blood glucose levels
• B. White blood cell count
• C. Blood pressure
• D. Heart rate

Correct answer: B

Rationale: The correct answer is B: White blood cell count. During chemotherapy, it is crucial to monitor the white blood cell count closely to detect potential neutropenia (low white blood cell count) and the associated risk of infections. Monitoring blood glucose levels (Choice A) is important for diabetic management and not directly related to chemotherapy. Blood pressure (Choice C) and heart rate (Choice D) are essential vital signs to monitor but are not the primary focus when monitoring a child receiving chemotherapy.

4. 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.

5. What is a common complication of uncontrolled type 1 diabetes in children?

• A. Hyperactivity
• B. Ketoacidosis
• C. Hypertension
• D. Hypoglycemia

Correct answer: B

Rationale: Ketoacidosis is a prevalent complication of uncontrolled type 1 diabetes in children. It is a serious condition characterized by high levels of ketones in the blood, leading to acidosis. Prompt medical attention is necessary to manage this potentially life-threatening condition. Choice A, hyperactivity, is not a typical complication of uncontrolled type 1 diabetes. Choice C, hypertension, is not a direct complication of type 1 diabetes in children. Choice D, hypoglycemia, is more commonly associated with low blood sugar levels, which can occur due to excessive insulin administration or inadequate food intake in diabetic individuals, rather than uncontrolled type 1 diabetes.

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