how should a nurse manage a child with a newly diagnosed congenital hypothyroidism

HESI LPN

HESI PN Nutrition Practice Exam

1. How should a healthcare provider manage a child with newly diagnosed congenital hypothyroidism?

A. Monitor for signs of hyperactivity
B. Ensure regular thyroid hormone replacement therapy
C. Encourage a high-calcium diet
D. Increase physical exercise

Correct answer: B

Rationale: Correct Answer: Ensuring regular thyroid hormone replacement therapy is crucial for managing congenital hypothyroidism in children. This therapy supports normal growth and development by replacing the deficient thyroid hormones. Monitoring for signs of hyperactivity (Choice A) is not the primary management for congenital hypothyroidism; rather, the focus should be on addressing the hormone deficiency. Encouraging a high-calcium diet (Choice C) may not directly address the thyroid hormone deficiency characteristic of congenital hypothyroidism. Increasing physical exercise (Choice D) is not the mainstay treatment for this condition; hormone replacement therapy is the cornerstone of management.

2. What is the main purpose of the initial assessment of a child with a suspected fracture?

A. To determine the type of fracture
B. To check for potential complications
C. To identify the cause of the injury
D. To plan for long-term rehabilitation

Correct answer: B

Rationale: The main purpose of the initial assessment of a child with a suspected fracture is to check for potential complications, such as neurovascular impairment, and to ensure appropriate treatment. Choice A is incorrect because determining the type of fracture usually requires imaging studies like X-rays, which may not be part of the initial assessment. Choice C is incorrect because identifying the cause of the injury is important for the history-taking part but may not be the main purpose of the initial assessment. Choice D is incorrect because long-term rehabilitation planning typically occurs after the acute phase of fracture management.

3. Which measure best describes the amounts of nutrients that should be consumed by the population?

A. The Dietary Reference Intakes, as they provide a set of nutrient intake values for healthy people in the United States and Canada
B. The Tolerable Upper Intake levels, as they indicate the maximum daily amount of a nutrient considered safe for most healthy people
C. The Estimated Average Requirements, as they reflect the average daily amount of a nutrient needed to maintain a specific function in half of the healthy individuals of a population
D. The Recommended Dietary Allowances, as they represent the average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy individuals

Correct answer: D

Rationale: The Recommended Dietary Allowances (RDAs) are the best measure to describe the amounts of nutrients that should be consumed by the population. RDAs represent the average daily intake level that meets the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group. Choice A, the Dietary Reference Intakes, provide a set of nutrient intake values but do not specifically address the average daily amount of a nutrient considered adequate for practically all individuals. Choice B, the Tolerable Upper Intake levels, focus on the maximum daily amount of a nutrient deemed safe for most healthy people, not the average daily amount needed. Choice C, the Estimated Average Requirements, reflect the average daily amount of a nutrient needed by half of the healthy individuals, which is not as comprehensive as the RDAs that cater to nearly all healthy people.

4. What should be monitored closely in a child receiving chemotherapy?

A. Blood glucose levels
B. White blood cell count
C. Blood pressure
D. Heart rate

Correct answer: B

Rationale: The correct answer is B: White blood cell count. During chemotherapy, it is crucial to monitor the white blood cell count closely to detect potential neutropenia (low white blood cell count) and the associated risk of infections. Monitoring blood glucose levels (Choice A) is important for diabetic management and not directly related to chemotherapy. Blood pressure (Choice C) and heart rate (Choice D) are essential vital signs to monitor but are not the primary focus when monitoring a child receiving chemotherapy.

5. What should be assessed in a child with suspected appendicitis?

A. Level of consciousness
B. Bowel sounds and pain location
C. Skin color and temperature
D. Heart rate and blood pressure

Correct answer: B

Rationale: The correct answer is to assess bowel sounds and pain location. In a child with suspected appendicitis, focusing on bowel sounds and pain location, particularly in the lower right quadrant, is crucial. This assessment helps to identify symptoms commonly associated with appendicitis. Assessing the level of consciousness (Choice A) is important in other conditions such as head injuries or neurological issues. Skin color and temperature (Choice C) are more indicative of circulatory or skin-related problems. Heart rate and blood pressure (Choice D) are vital signs that are essential to assess in various conditions but are not specific to suspected appendicitis.