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Pediatric ATI Proctored Test
1. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?
- A. 5% dextrose infusion
- B. Normal saline infusion
- C. NPH insulin infusion
- D. Potassium infusion
Correct answer: B
Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.
2. Use the scenario to answer questions 13-18. A patient has come to the OPD with complaints of anaesthesia and paresthesia of the lower limbs. After laboratory investigations, the doctor has diagnosed the patient with Diabetes Mellitus but failed to specify whether it is type 1 or type 2. Onset of Type 1 diabetes is characterized by:
- A. Occurs after pubertal onset in the majority of cases
- B. Occurs when parents are poor
- C. Occurs at an early age
- D. Occurs after childbirth
Correct answer: A
Rationale: Type 1 diabetes typically occurs after pubertal onset. This form of diabetes is most commonly diagnosed in individuals under the age of 30, with a peak incidence in the mid-teens to early 20s. Puberty is a period of hormonal changes and growth, which can trigger the onset of type 1 diabetes due to the stress it places on the body's insulin-producing cells.
3. As a nurse caring for Asana, a 9-year-old girl with the stature of a 4-year-old due to growth hormone deficiency, which of the following will be your priority during follow-up visits?
- A. Vital signs monitoring
- B. Height and weight monitoring
- C. Bone age studies
- D. Dietary assessment
Correct answer: B
Rationale: Height and weight monitoring are essential for evaluating the growth progress in a child with growth hormone deficiency. Regular monitoring helps assess the effectiveness of treatment and ensures appropriate growth trajectory for the child.
4. Which statement best describes direct contact as a mode of pathogen transmission?
- A. Transmission through large aerosols produced by sneezing or coughing
- B. Transfer of an infectious agent by suspended air particles from a reservoir to a host
- C. Transmission of infectious agents carried by dust
- D. Transmission through skin-to-skin contact or body fluids
Correct answer: D
Rationale: Direct contact transmission occurs when pathogens are spread through skin-to-skin contact or body fluids. This mode of transmission includes activities like touching, kissing, or sexual contact where infectious agents can pass directly from one person to another. It does not involve large aerosols, suspended air particles, or dust as carriers of the pathogen.
5. What is the term for a condition where there is a failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children, with 80% of cases being idiopathic? It may present with familial patterns, affecting males more than females.
- A. Cretinism
- B. Growth hormone deficiency
- C. Hypothyroidism
- D. Precocious puberty
Correct answer: B
Rationale: Growth hormone deficiency refers to a condition where there is inadequate production of growth hormone by the pituitary gland. This results in impaired growth in children. While 80% of cases are of unknown cause (idiopathic), some may have familial patterns. It is more common in males than females. Cretinism is a condition of severe hypothyroidism during infancy, not related to growth hormone. Hypothyroidism is a disorder involving low thyroid hormone levels, and precocious puberty is the early onset of puberty. Therefore, the correct answer is 'Growth hormone deficiency.'
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