Nursing Elites

1. What is the priority assessment for a child with suspected appendicitis?

• A. Temperature
• B. Heart rate
• C. Respiratory rate
• D. Pain level

Correct answer: D

Rationale: The priority assessment for a child with suspected appendicitis is 'Pain level.' Evaluating the pain level, particularly in the lower right quadrant, is crucial as it helps in determining the severity of the condition, leading to prompt diagnosis and treatment. Monitoring temperature, heart rate, and respiratory rate are important aspects of assessment; however, they are secondary to assessing the pain level in cases of suspected appendicitis. Pain assessment is key in diagnosing this condition since the classic presentation includes abdominal pain that often starts around the umbilicus and then localizes to the right lower quadrant.

2. 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.

3. How should a healthcare professional respond to a parent concerned about their child's weight gain?

• A. Provide guidance on healthy eating and physical activity
• B. Suggest restrictive dieting
• C. Recommend increased caloric intake
• D. Avoid discussing the issue

Correct answer: A

Rationale: When a parent expresses concern about their child's weight gain, the most appropriate response is to provide guidance on healthy eating and physical activity. This approach promotes healthy weight management and overall well-being. Suggesting restrictive dieting (Choice B) can be harmful, especially for children, as it may lead to unhealthy relationships with food and potential nutritional deficiencies. Recommending increased caloric intake (Choice C) without proper assessment and guidance can exacerbate the issue. Avoiding discussing the issue (Choice D) neglects a critical opportunity to address the parent's concerns and support the child's health.

4. What is the most common symptom of appendicitis in children?

• A. Vomiting and diarrhea
• B. Fever and abdominal pain
• C. Rash and joint pain
• D. Difficulty breathing

Correct answer: B

Rationale: The correct answer is B: Fever and abdominal pain. In children, appendicitis commonly presents with fever and abdominal pain. The pain typically begins around the umbilicus and then moves to the lower right quadrant. Choices A, C, and D are incorrect because vomiting and diarrhea, rash and joint pain, and difficulty breathing are not typical symptoms of appendicitis in children.

5. What is the most effective therapy for maintaining remission of acute lymphoblastic leukemia?

• A. Surgery to remove enlarged lymph nodes
• B. Long-term chemotherapy
• C. Nutritional supplements to enhance blood cell production
• D. Blood transfusions to replace ineffective red cells

Correct answer: B

Rationale: The correct answer is B: Long-term chemotherapy. Long-term chemotherapy, specifically with methotrexate, is the most effective therapy for maintaining remission in acute lymphoblastic leukemia. Surgery to remove enlarged lymph nodes (Choice A) is not the primary treatment for leukemia. Nutritional supplements (Choice C) may support overall health but are not the mainstay therapy for maintaining leukemia remission. Blood transfusions (Choice D) are used to address anemia in some cases but are not the primary treatment for maintaining remission in acute lymphoblastic leukemia.

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