Nursing Elites

1. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.

2. The parents of a 6-month-old infant are concerned about the risk of sudden infant death syndrome (SIDS). What should the nurse recommend to reduce the risk?

• A. Place the infant on their back to sleep
• B. Use a pacifier during sleep
• C. Have the infant sleep on their side
• D. Keep the infant's room cool

Correct answer: A

Rationale: The correct recommendation to reduce the risk of SIDS in infants is to place them on their back to sleep. This sleeping position helps prevent the occurrence of SIDS by maintaining an open airway and reducing the risk of suffocation. Using a pacifier during sleep has also shown some protective effect against SIDS, but it is not as effective as placing the infant on their back. Having the infant sleep on their side is not recommended as it can increase the risk of accidental suffocation. Keeping the infant's room cool does not directly reduce the risk of SIDS.

3. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?

• A. Monitor for signs of infection
• B. Monitor blood pressure
• C. Monitor for hyperglycemia
• D. Monitor for hypertension

Correct answer: A

Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention. While monitoring blood pressure, hyperglycemia, and hypertension are important considerations in certain conditions and treatments, they are not the primary concern when a child with nephrotic syndrome is on corticosteroid therapy.

4. What is the typical therapeutic management treatment for children with Hirschsprung disease?

• A. Daily enemas
• B. Low-fiber diet
• C. Permanent colostomy
• D. Surgical removal of affected section of bowel

Correct answer: D

Rationale: The most common treatment for Hirschsprung disease is the surgical removal of the affected section of the bowel. This procedure entails excising the part of the colon that lacks nerve cells crucial for normal bowel function. Daily enemas (Choice A) can offer temporary relief for constipation but do not address the root cause of the condition, which is the absence of nerve cells. A low-fiber diet (Choice B) is not a primary therapy for Hirschsprung disease and may not effectively manage the disorder. A permanent colostomy (Choice C) is typically considered in severe cases where other interventions have failed and is not the standard management approach for Hirschsprung disease.

5. 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 stops when puberty begins
• D. Educating the parents to report signs of acute adrenal crisis

Correct answer: B

Rationale: In a child with a disorder of the posterior pituitary gland, desmopressin acetate is commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents to administer desmopressin acetate correctly is essential for the child's treatment. The other options are incorrect because growth hormone treatment, stopping treatment at puberty, and reporting signs of acute adrenal crisis are not directly related to managing a disorder of the posterior pituitary gland.

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