Nursing Elites

1. What is the most common cause of abdominal pain in school-aged children?

• A. Gastroenteritis
• B. Constipation
• C. Appendicitis
• D. Irritable bowel syndrome

Correct answer: B

Rationale: Constipation is the most common cause of abdominal pain in school-aged children. It is often due to dietary factors such as low fiber intake or insufficient fluid consumption. Chronic constipation can lead to complications like fecal impaction and soiling, highlighting the importance of early recognition and treatment. Gastroenteritis, although common, typically presents with diarrhea and vomiting. Appendicitis is more common in adolescents and typically presents with right lower quadrant pain. Irritable bowel syndrome is less common in children and is characterized by recurrent abdominal pain associated with defecation.

2. A child who weighs 10 kg is to receive Motrin 8 mg/kg po q4h prn for pain. The label reads 100 mg/5 mL. How much will you administer?

• A. 4 mL
• B. 2 mL
• C. 5 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage, multiply the child's weight (10 kg) by the dosage (8 mg/kg) which equals 80 mg. Since the concentration is 100 mg/5 mL, to find out how much to administer, you need to determine how many 5 mL doses are in 80 mg. It will be 80 mg ÷ 100 mg * 5 mL = 4 mL. Therefore, the correct answer is 4 mL. Choice B, 2 mL, is incorrect because it does not account for the correct dosage calculation. Choice C, 5 mL, is incorrect as it does not consider the dosage based on the child's weight. Choice D, 3 mL, is incorrect as it does not reflect the accurate dosage calculation.

3. Urinary tract anomalies are frequently associated with what irregularities in fetal development?

• A. Myelomeningocele
• B. Cardiovascular anomalies
• C. Malformed or low-set ears
• D. Defects in lower extremities

Correct answer: C

Rationale: Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.

4. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?

• A. It prevents the cremasteric reflex
• B. Undescended testes can be palpated
• C. The child has an inguinal hernia
• D. The child does not yet have a need for privacy

Correct answer: A

Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.

5. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?

• A. At bedtime
• B. With a meal
• C. Midmorning
• D. 30 minutes before breakfast

Correct answer: D

Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.

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