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. A weight reduction regimen calls for a daily intake of 1400 kilocalories, which includes 30 grams of fat. What percentage of the total energy is contributed by fat?

• A. 8.50%
• B. 15.00%
• C. 19.00%
• D. 25.50%

Correct answer: C

Rationale: To calculate the percentage of total energy contributed by fat, first determine the energy from fat by multiplying the fat amount (30g) by the energy density of fat (9 kcal/g), which equals 270 kcal. Then, divide the energy from fat (270 kcal) by the total energy intake (1400 kcal) and multiply by 100 to find the percentage: (270 kcal / 1400 kcal) * 100 = 19.29% ≈ 19.00%. Therefore, fat contributes approximately 19% of the total energy in the diet. Choice A (8.50%) is too low, while choices B (15.00%) and D (25.50%) are incorrect calculations based on the given information.

3. What is a common sign of developmental dysplasia of the hip (DDH) in infants?

• A. Dislocated patella
• B. Limited abduction of the hip
• C. Swelling of the knee
• D. Hyperextension of the leg

Correct answer: B

Rationale: Limited abduction of the hip is a common sign of developmental dysplasia of the hip in infants. It indicates possible hip dislocation or instability, making it a key clinical manifestation to assess for DDH. Dislocated patella (Choice A) is not typically associated with DDH. Swelling of the knee (Choice C) and hyperextension of the leg (Choice D) are not specific signs linked to DDH in infants, further supporting why they are incorrect choices.

4. 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.

5. What is an important nursing intervention for a child with a newly inserted central venous catheter?

• A. Regularly monitor for signs of infection
• B. Administer intravenous fluids only as ordered
• C. Restrict the child's movement
• D. Perform daily dressing changes only

Correct answer: A

Rationale: Regularly monitoring for signs of infection is a critical nursing intervention for a child with a newly inserted central venous catheter. This intervention is essential to detect any early signs of infection, such as redness, swelling, or drainage at the catheter site, which can lead to serious complications like sepsis. Administering intravenous fluids as ordered is important but not the most crucial intervention for a newly inserted central venous catheter. Restricting the child's movement is unnecessary unless specified by the healthcare provider. Performing daily dressing changes alone is not sufficient to ensure the catheter's integrity and the child's safety; monitoring for signs of infection is key.

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