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. Which of the following is a common complication of an untreated inguinal hernia in children?

• A. Gastroenteritis
• B. Strangulation of the hernia
• C. Chronic cough
• D. Epistaxis

Correct answer: B

Rationale: The correct answer is B: Strangulation of the hernia. Untreated inguinal hernias in children can lead to strangulation, which can result in bowel obstruction and ischemia. This is a serious complication that requires prompt medical attention. Choices A, C, and D are incorrect. Gastroenteritis is a gastrointestinal infection that is not directly related to untreated inguinal hernias. Chronic cough is not typically associated with this condition. Epistaxis refers to nosebleeds, which are not a common complication of untreated inguinal hernias in children.

3. How should the healthcare provider respond to a parent concerned about a child's short stature?

• A. Suggest the parent consult a nutritionist
• B. Recommend frequent growth hormone injections
• C. Advise monitoring for a few years before intervention
• D. Refer for a genetic evaluation

Correct answer: C

Rationale: When a parent expresses concern about a child's short stature, the initial approach should involve advising monitoring for a few years before considering any interventions. This allows for observation of the child's growth pattern and any potential underlying issues. Suggesting a nutritionist (Choice A) may not be necessary if there are no signs of nutritional deficiencies. Recommending growth hormone injections (Choice B) is premature without proper evaluation and diagnosis. Referring for a genetic evaluation (Choice D) can be considered later if monitoring shows atypical growth patterns or other concerning factors.

4. How should hydration status in a child with fever and vomiting be assessed?

• A. Monitor skin turgor and mucous membranes
• B. Measure blood glucose levels
• C. Check for signs of jaundice
• D. Assess respiratory rate

Correct answer: A

Rationale: To assess hydration status in a child with fever and vomiting, monitoring skin turgor and mucous membranes is essential. Skin turgor refers to the skin's ability to change shape and return to normal; poor skin turgor can indicate dehydration. Mucous membranes, such as the mouth and eyes, can also provide valuable information about hydration levels. Measuring blood glucose levels (Choice B) is not directly related to assessing hydration status. Checking for signs of jaundice (Choice C) is important for liver-related issues, not hydration assessment. Assessing respiratory rate (Choice D) is crucial for evaluating respiratory function, not hydration status.

5. What is an important dietary consideration for a child with celiac disease?

• A. Increased iron intake
• B. Gluten-free diet
• C. High-protein diet
• D. Low-sodium diet

Correct answer: B

Rationale: A gluten-free diet is crucial for managing celiac disease in children because it helps prevent intestinal damage and alleviate symptoms. Gluten is a protein found in wheat, barley, and rye, and it triggers an immune response in individuals with celiac disease, damaging the lining of the small intestine. Therefore, choices A, C, and D are incorrect. While iron intake is important for overall health, a child with celiac disease can still meet their iron needs through sources that are naturally gluten-free or fortified. A high-protein diet or a low-sodium diet are not specifically required for managing celiac disease.

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