what should be monitored in a child with congenital adrenal hyperplasia cah
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HESI PN Nutrition Practice Exam

1. What should be monitored in a child with congenital adrenal hyperplasia (CAH)?

Correct answer: B

Rationale: In a child with congenital adrenal hyperplasia (CAH), monitoring electrolyte balance is crucial. CAH can lead to adrenal insufficiency, causing imbalances in electrolytes such as sodium and potassium. Monitoring electrolyte levels helps in preventing complications like dehydration, electrolyte disturbances, and adrenal crisis. While blood glucose levels may need monitoring in other conditions like diabetes, it is not the primary concern in CAH. Urine output is important in assessing kidney function but is not a direct monitoring parameter for CAH. Hemoglobin levels are more relevant in conditions such as anemia, not specifically in CAH.

2. What is the first-line treatment for a child with a bacterial ear infection?

Correct answer: B

Rationale: The correct answer is B: Oral antibiotics. Oral antibiotics are the first-line treatment for bacterial ear infections in children as they effectively target the infection at the source and help alleviate symptoms. Intravenous antibiotics (Choice A) are typically reserved for severe cases where oral antibiotics are not sufficient. Nasal decongestants (Choice C) and antihistamines (Choice D) are not the primary treatments for bacterial ear infections. Nasal decongestants are used for nasal congestion, and antihistamines are used for allergies. However, these medications do not directly address the bacterial infection in the ear, unlike oral antibiotics.

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

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.

4. What is the appropriate intervention for a child with an undescended testicle?

Correct answer: B

Rationale: The appropriate intervention for a child with an undescended testicle is to perform an orchidopexy. This surgical procedure is recommended if the testicle has not descended naturally within the first year of life. Waiting until puberty is not advised as early intervention is crucial for optimal outcomes. Administering hormone therapy is not the first-line treatment for an undescended testicle and is typically not recommended. Increasing physical activity does not address the underlying issue of an undescended testicle and is not a suitable intervention.

5. How should a healthcare provider handle a child with a suspected head injury who is showing signs of drowsiness?

Correct answer: B

Rationale: When a child with a suspected head injury is showing signs of drowsiness, administering pain medication should not be the first course of action as it may mask important symptoms. Allowing the child to sleep is not recommended as they need to be monitored. Contacting a specialist immediately may delay necessary assessments. Performing a full neurological assessment is the most appropriate action because it helps evaluate the head injury's extent, identify neurological deficits, and guide further intervention or treatment.

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