Nursing Elites

1. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?

• A. Instructing the parents to report adverse reactions to the growth hormone treatment
• B. Teaching the parents how to administer desmopressin acetate
• C. Informing the parents that treatment continues during puberty
• D. Educating the parents to report signs of acute adrenal crisis

Correct answer: B

Rationale: For a child with a disorder of the posterior pituitary gland, desmopressin acetate is a medication commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents on how to administer desmopressin acetate correctly is essential for the child's care. Choice A is incorrect because growth hormone treatment is not typically used for posterior pituitary disorders. Choice C is incorrect as treatment for this condition usually continues beyond puberty. Choice D is incorrect as acute adrenal crisis is not directly related to a disorder of the posterior pituitary gland.

2. When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?

• A. They may occur in minor illnesses.
• B. The cause is usually readily identified.
• C. They usually do not occur during the toddler years.
• D. The frequency of occurrence is greater in females than males.

Correct answer: A

Rationale: The correct answer is A: 'They may occur in minor illnesses.' Febrile seizures can occur even in minor illnesses, particularly in young children, and are often triggered by a rapid increase in body temperature. Choice B is incorrect because the cause of febrile seizures is not always readily identified. Choice C is incorrect as febrile seizures commonly occur in children between the ages of 6 months to 5 years, which includes the toddler years. Choice D is incorrect as febrile seizures are slightly more common in males than females.

3. When evaluating the laboratory report of a 1-year-old infant’s hematocrit, a healthcare provider compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?

• A. 19% to 32%
• B. 29% to 41%
• C. 37% to 47%
• D. 42% to 69%

Correct answer: C

Rationale: The correct hematocrit range for a healthy 12-month-old infant is between 37% to 47%. At this age, this range reflects the normal blood volume and red blood cell (RBC) levels in infants. Choice A (19% to 32%) is too low for a healthy hematocrit level in a 12-month-old. Choice B (29% to 41%) is also below the typical range for a 12-month-old. Choice D (42% to 69%) includes an upper limit that is higher than expected for a healthy infant, making it an incorrect option.

4. You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation?

• A. Inform the parents of your suspicions.
• B. Call the police so the parents can be arrested.
• C. Advise the parents that the child needs to be transported.
• D. Transport the child to the hospital regardless of the parents' wishes.

Correct answer: C

Rationale: In cases where child abuse is suspected, it is crucial to prioritize the safety and well-being of the child. Advising the parents that the child needs to be transported allows for the child to receive necessary medical care without immediate confrontation. Calling the police to have the parents arrested (Choice B) may escalate the situation and should only be done after ensuring the child's safety. Informing the parents of suspicions (Choice A) may potentially place the child at further risk if the parents are the abusers. Transporting the child to the hospital regardless of the parents' wishes (Choice D) could lead to legal and ethical complications; it is important to involve the appropriate authorities and handle the situation with sensitivity and care.

5. What behavior does the nurse anticipate while feeding a newborn with choanal atresia?

• A. Chokes on the feeding
• B. Has difficulty swallowing
• C. Does not appear to be hungry
• D. Takes about half of the feeding

Correct answer: D

Rationale: Correct answer: When feeding a newborn with choanal atresia, the nurse should anticipate that the infant may take only part of the feeding. This behavior is due to the condition causing difficulty in breathing through the nose while feeding, prompting the infant to pause for air. Choice A, 'Chokes on the feeding,' is incorrect as it does not specifically relate to the feeding behavior expected in choanal atresia. Choice B, 'Has difficulty swallowing,' is also incorrect because the issue in choanal atresia is primarily related to breathing rather than swallowing. Choice C, 'Does not appear to be hungry,' is not the typical behavior seen in infants with choanal atresia; they may still display hunger cues but struggle with feeding due to the condition.

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