Nursing Elites

1. A child is being assessed for suspected appendicitis. What clinical manifestation is the healthcare professional likely to observe?

• A. Right lower quadrant pain
• B. Left lower quadrant pain
• C. Rebound tenderness
• D. Epigastric pain

Correct answer: A

Rationale: Right lower quadrant pain is a classic symptom of appendicitis. The appendix is typically located in the right lower quadrant of the abdomen, so pain in this area is commonly associated with appendicitis. Choices B, C, and D are incorrect because left lower quadrant pain, rebound tenderness, and epigastric pain are not typical manifestations of appendicitis. Left lower quadrant pain is not associated with appendicitis since the appendix is situated in the right lower quadrant. Rebound tenderness is more commonly linked with peritonitis rather than appendicitis. Epigastric pain is not a typical presentation of appendicitis as the pain is usually localized to the right lower quadrant.

2. A child with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing symptoms and ensuring proper nutrition in children with ADHD. Dietary factors can influence ADHD symptoms. While sleep patterns, academic performance, and behavior at home are important aspects to consider, dietary assessment plays a significant role in the management of ADHD.

3. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential in managing type 1 diabetes mellitus as it helps in monitoring blood sugar levels at different times of the day and adjusting insulin doses accordingly. Option B about using a lancet device to obtain blood samples is a technique rather than an emphasis on monitoring frequency. Option C suggesting the use of urine test strips is incorrect as urine test strips are not recommended for accurate real-time monitoring of blood glucose levels in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when educating about blood glucose monitoring.

4. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is B: 'Avoid gluten.' Celiac disease is a condition in which the immune system reacts to gluten, a protein found in wheat, barley, and rye. Avoiding gluten is essential in managing celiac disease as it helps prevent damage to the small intestine and alleviate symptoms. Choices A, C, and D are incorrect because dairy products, high-fat foods, and foods high in sugar do not directly relate to the management of celiac disease. It is crucial to focus on eliminating gluten-containing foods to effectively control the condition.

5. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration. What should the nurse emphasize?

• A. Rotate injection sites
• B. Administer insulin before meals
• C. Store insulin in the refrigerator
• D. Administer insulin at bedtime

Correct answer: A

Rationale: The correct answer is to rotate injection sites. Rotating injection sites is crucial in insulin administration to prevent lipodystrophy, which is the breakdown of subcutaneous fat at the injection site. It also helps ensure consistent insulin absorption. Administering insulin before meals (choice B) is important to match insulin peak action with the rise in blood glucose after eating. Storing insulin in the refrigerator (choice C) is correct to maintain its potency and stability. Administering insulin at bedtime (choice D) may not be suitable for all patients and is not a universal recommendation for insulin administration.

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