Nursing Elites

1. 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.

2. A 7-year-old child named Kanjaga exhibits symptoms like fatigue, slow heart rate, dry skin, slower growth, and delayed puberty. Which of the following is the appropriate diagnosis for this deficiency that slows body processes?

• A. Diabetes
• B. Hypothyroidism
• C. Growth hormone deficiency
• D. Stunted growth

Correct answer: B

Rationale: The appropriate diagnosis for the symptoms described in Kanjaga, a 7-year-old child, is hypothyroidism. Hypothyroidism can lead to symptoms such as fatigue, slow heart rate, dry skin, slower growth, and delayed puberty in children.

3. In educating the parents of a child diagnosed with hypothyroidism, the nurse mentions that the child should avoid goitrogens. Which of the following will the nurse mention as an example?

• A. Orange
• B. Tomatoes
• C. Cabbage
• D. Grapes

Correct answer: C

Rationale: Cabbage is an example of a goitrogen that should be avoided in children with hypothyroidism. Goitrogens are substances that can interfere with thyroid function by inhibiting iodine uptake, potentially worsening the condition. Cabbage, along with other cruciferous vegetables like broccoli and cauliflower, contains compounds that can affect thyroid hormone production. Oranges, tomatoes, and grapes are not classified as goitrogens. Therefore, it is important for parents to be aware of foods like cabbage and to limit their child's intake to help manage their hypothyroidism effectively.

4. A breastfeeding mother reports breast engorgement. The nurse advises her to:

• A. Increase the frequency of feedings
• B. Apply ice packs to the breasts
• C. Avoid breastfeeding until the pain subsides
• D. Use a breast pump to empty the breasts completely

Correct answer: A

Rationale: Breast engorgement occurs when the breasts become overfilled with milk. By increasing the frequency of feedings, the mother can ensure that her breasts are emptied regularly, helping to relieve the discomfort associated with engorgement. This advice promotes effective milk removal and prevents further accumulation, which can worsen the condition. Applying ice packs may provide temporary relief, but it does not address the underlying issue of milk accumulation. Avoiding breastfeeding can lead to further engorgement and potential complications. Using a breast pump to empty the breasts completely may be necessary in some cases, but increasing the frequency of feedings is the initial and most appropriate intervention to manage breast engorgement.

5. Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and takes steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?

• A. Sodium bicarbonate from renal compensation
• B. Potassium from cell death
• C. Glucose from carbohydrate metabolism
• D. Ketone bodies from fat metabolism

Correct answer: D

Rationale: Diabetic ketoacidosis (DKA) results from the excessive accumulation of ketone bodies from fat metabolism. During DKA, there is a lack of insulin leading to the breakdown of fat stores into fatty acids and their subsequent conversion into ketone bodies. These ketone bodies accumulate in the blood, leading to metabolic acidosis and the characteristic symptoms of DKA.

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