Nursing Elites

1. How should the healthcare provider respond to a parent concerned about a child's short stature?

• A. Suggest the parent consult a nutritionist
• B. Recommend frequent growth hormone injections
• C. Advise monitoring for a few years before intervention
• D. Refer for a genetic evaluation

Correct answer: C

Rationale: When a parent expresses concern about a child's short stature, the initial approach should involve advising monitoring for a few years before considering any interventions. This allows for observation of the child's growth pattern and any potential underlying issues. Suggesting a nutritionist (Choice A) may not be necessary if there are no signs of nutritional deficiencies. Recommending growth hormone injections (Choice B) is premature without proper evaluation and diagnosis. Referring for a genetic evaluation (Choice D) can be considered later if monitoring shows atypical growth patterns or other concerning factors.

2. 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.

3. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

4. What is an important aspect of managing a child with chronic kidney disease?

• A. Monitoring electrolyte levels
• B. Increasing protein intake
• C. Limiting fluid intake
• D. Encouraging a high-fat diet

Correct answer: A

Rationale: Monitoring electrolyte levels is crucial in managing chronic kidney disease in children because imbalances can lead to serious complications. Electrolyte levels must be carefully monitored to prevent issues such as electrolyte abnormalities, which can further impact kidney function and overall health. Choices B, C, and D are incorrect because increasing protein intake, limiting fluid intake, and encouraging a high-fat diet can exacerbate kidney disease in children by putting extra strain on their kidneys or causing other health problems.

5. How should a healthcare provider respond to a parent concerned about their child's frequent ear infections?

• A. Recommend over-the-counter ear drops
• B. Suggest an ENT specialist evaluation
• C. Advise on increasing fluid intake
• D. Encourage more physical exercise

Correct answer: B

Rationale: When a parent expresses concerns about their child's frequent ear infections, suggesting an ENT specialist evaluation is the most appropriate response. This specialist can conduct a thorough examination to identify the underlying cause of the recurrent infections and recommend the most suitable treatment. Recommending over-the-counter ear drops (Choice A) may not address the root cause of the issue and could potentially lead to inappropriate treatment. Advising on increasing fluid intake (Choice C) and encouraging more physical exercise (Choice D) are unrelated to addressing the specific concern of frequent ear infections.

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