Nursing Elites

1. What is the most common initial symptom of juvenile idiopathic arthritis?

• A. Joint swelling and pain
• B. Skin rash
• C. Gastrointestinal bleeding
• D. Neurological deficits

Correct answer: A

Rationale: The correct answer is A: Joint swelling and pain. These are the most common initial symptoms of juvenile idiopathic arthritis, typically affecting multiple joints. Skin rash (choice B), gastrointestinal bleeding (choice C), and neurological deficits (choice D) are not typical initial symptoms of juvenile idiopathic arthritis. Skin rash may be seen in other conditions like dermatitis or systemic lupus erythematosus, gastrointestinal bleeding may be associated with conditions like inflammatory bowel disease, and neurological deficits could be indicative of conditions like multiple sclerosis.

2. How is gastroesophageal reflux (GER) typically treated in infants?

• A. Keeping the infant NPO
• B. Thickening the formula or breast milk with cereal
• C. Placing the infant to sleep on the side
• D. Switching the infant to cow's milk

Correct answer: B

Rationale: Thickening the formula or breast milk with cereal is a common treatment for gastroesophageal reflux (GER) in infants. By adding cereal, the feedings become heavier, making it less likely for the stomach contents to reflux. Keeping the infant NPO (nothing by mouth) is not typically necessary for GER treatment and might not be appropriate. Placing the infant to sleep on the side is not recommended due to the risk of sudden infant death syndrome (SIDS). Switching the infant to cow's milk is also not a recommended treatment for GER as it can exacerbate symptoms due to its protein content.

3. What is the primary purpose of a placebo in an experiment?

• A. To reduce the cost of the experiment.
• B. To make the experiment double-blind.
• C. To increase the number of participants.
• D. To serve as a control for comparison with the treatment group.

Correct answer: D

Rationale: The correct answer is D. A placebo serves as a control for comparison with the treatment group, helping to eliminate bias and ensure the results are due to the treatment itself. Placebos are crucial in research to distinguish the actual effect of the treatment from psychological or subjective factors. Choice A is incorrect because the purpose of a placebo is not related to reducing the cost of the experiment. Choice B is incorrect because while placebos are used in double-blind studies, their primary purpose is not to make the experiment double-blind. Choice C is incorrect because the purpose of a placebo is not to increase the number of participants but rather to serve as a comparison group for the treatment being tested.

4. How should a healthcare provider manage a child with newly diagnosed congenital hypothyroidism?

• A. Monitor for signs of hyperactivity
• B. Ensure regular thyroid hormone replacement therapy
• C. Encourage a high-calcium diet
• D. Increase physical exercise

Correct answer: B

Rationale: Correct Answer: Ensuring regular thyroid hormone replacement therapy is crucial for managing congenital hypothyroidism in children. This therapy supports normal growth and development by replacing the deficient thyroid hormones. Monitoring for signs of hyperactivity (Choice A) is not the primary management for congenital hypothyroidism; rather, the focus should be on addressing the hormone deficiency. Encouraging a high-calcium diet (Choice C) may not directly address the thyroid hormone deficiency characteristic of congenital hypothyroidism. Increasing physical exercise (Choice D) is not the mainstay treatment for this condition; hormone replacement therapy is the cornerstone of management.

5. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

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