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. The parents of a child with sickle cell anemia ask why their child experiences pain. What is the most likely cause?

• A. Inflammation of the vessels
• B. Obstructed blood flow
• C. Overhydration
• D. Stress-related headaches

Correct answer: B

Rationale: In sickle cell anemia, pain is primarily caused by the obstruction of blood flow by sickle-shaped cells. This obstruction leads to inadequate oxygen supply to tissues, resulting in tissue damage and pain. Choice A, inflammation of the vessels, is incorrect as it is not the primary cause of pain in sickle cell anemia. Choice C, overhydration, is unrelated to the pathophysiology of sickle cell anemia and would not lead to the characteristic pain experienced. Choice D, stress-related headaches, is also unrelated to the underlying mechanisms of pain in sickle cell anemia.

3. What is a key sign of meningitis in an infant?

• A. Increased appetite
• B. Bulging fontanel
• C. Decreased respiratory rate
• D. Elevated blood pressure

Correct answer: B

Rationale: A bulging fontanel is a key sign of meningitis in infants, indicating increased intracranial pressure due to inflammation of the meninges. This can lead to the fontanel bulging. Choices A, C, and D are incorrect. Increased appetite is not typically associated with meningitis in infants; instead, they may have poor feeding. A decreased respiratory rate is not a common sign of meningitis in infants. Elevated blood pressure is also not a typical finding in infants with meningitis.

4. What is an important consideration when administering medications to a child with hepatic dysfunction?

• A. Increased dosing intervals
• B. Adjustments in dosage due to altered metabolism
• C. Avoid all medications
• D. Use only topical medications

Correct answer: B

Rationale: When administering medications to a child with hepatic dysfunction, it is crucial to make adjustments in dosage due to altered metabolism. Hepatic dysfunction can affect the way medications are metabolized in the body, potentially leading to drug toxicity or reduced effectiveness. This is why adjusting the dosage is essential to ensure the medication is both safe and efficient. Choices A, C, and D are incorrect because increasing dosing intervals, avoiding all medications, or using only topical medications do not address the specific issue of altered drug metabolism in hepatic dysfunction.

5. What is the main purpose of the initial assessment of a child with a suspected fracture?

• A. To determine the type of fracture
• B. To check for potential complications
• C. To identify the cause of the injury
• D. To plan for long-term rehabilitation

Correct answer: B

Rationale: The main purpose of the initial assessment of a child with a suspected fracture is to check for potential complications, such as neurovascular impairment, and to ensure appropriate treatment. Choice A is incorrect because determining the type of fracture usually requires imaging studies like X-rays, which may not be part of the initial assessment. Choice C is incorrect because identifying the cause of the injury is important for the history-taking part but may not be the main purpose of the initial assessment. Choice D is incorrect because long-term rehabilitation planning typically occurs after the acute phase of fracture management.

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