Nursing Elites

1. Which lab result should be abnormal in a child with hemophilia?

• A. Prothrombin time
• B. Bleeding time
• C. Platelet count
• D. Partial thromboplastin time

Correct answer: D

Rationale: In a child with hemophilia, the lab result that should be abnormal is the partial thromboplastin time (PTT). Hemophilia is a disorder that affects the clotting factors in the intrinsic pathway of coagulation, leading to a prolonged PTT. Prothrombin time (Choice A) assesses the extrinsic pathway and should be normal in hemophilia. Bleeding time (Choice B) evaluates platelet function, which is typically normal in hemophilia. Platelet count (Choice C) measures the number of platelets and is not directly affected by hemophilia.

2. What should be assessed first in a child with suspected head trauma?

• A. Response to verbal stimuli
• B. Pupillary reaction
• C. Skin color
• D. Heart rate

Correct answer: A

Rationale: The correct answer is to assess the response to verbal stimuli first in a child with suspected head trauma. This assessment helps in determining the child's level of consciousness and neurological status. Assessing the response to verbal stimuli allows healthcare providers to quickly evaluate if the child is alert, oriented, and able to communicate effectively. This initial assessment is crucial in identifying any immediate concerns related to the child's neurological function. Choices B, C, and D are not the primary assessments in cases of suspected head trauma. While pupillary reaction, skin color, and heart rate are important assessments in trauma situations, assessing the response to verbal stimuli takes precedence in evaluating the neurological status of a child with head trauma.

3. What is the primary intervention for a child experiencing a tonic-clonic seizure?

• A. Administer intravenous fluids
• B. Place the child in a prone position
• C. Protect the child from injury
• D. Perform mouth-to-mouth resuscitation

Correct answer: C

Rationale: The primary intervention for a child experiencing a tonic-clonic seizure is to protect them from injury. Placing the child in a prone position can be dangerous as it may lead to further harm due to the risk of aspiration or airway obstruction. Administering intravenous fluids is not recommended during a seizure. Performing mouth-to-mouth resuscitation is also not indicated as the child will resume breathing spontaneously after the seizure stops. Ensuring the child's safety and preventing injury by removing harmful objects and cushioning their head is essential until the seizure subsides.

4. 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.

5. 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.

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