Nursing Elites

1. Which clinical manifestations should the nurse anticipate when assessing a child for hypoglycemia?

• A. Lethargy
• B. Thirst
• C. Nausea and vomiting
• D. Shaky feeling and dizziness

Correct answer: D

Rationale: The correct answer is D: 'Shaky feeling and dizziness.' Hypoglycemia in children often presents with symptoms like shakiness, dizziness, sweating, hunger, and irritability. These symptoms occur because the brain and body are deprived of the glucose they need to function properly. Choices A, B, and C are incorrect because lethargy, thirst, nausea, and vomiting are not typically primary manifestations of hypoglycemia in children.

2. At what age is the first dose of the hepatitis A vaccine recommended to be started?

• A. 1 year
• B. 1 month
• C. 12 years
• D. It is not recommended at any age

Correct answer: A

Rationale: The correct answer is A: 1 year. The hepatitis A vaccine is now recommended for all children starting at age 1 year (i.e., 12 to 23 months). This is due to the recognition of hepatitis A as a significant child health problem, especially in areas with high infection rates. The virus is primarily spread through fecal-oral transmission, person-to-person contact, ingestion of contaminated food or water, and rarely through blood transfusion. Administering the first dose at 1 year helps protect children from this infection. Choices B and C are incorrect as the vaccine is not recommended at 1 month or 12 years. Choice D is also incorrect as the hepatitis A vaccine is recommended at a specific age to prevent the infection.

3. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

• A. Isotonic dehydration
• B. Hypotonic dehydration
• C. Hypertonic dehydration
• D. Hyperosmotic dehydration

Correct answer: B

Rationale: Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.

4. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?

• A. Acute diarrhea and dehydration
• B. Current jelly-like stools and pain
• C. Failure to pass meconium and abdominal distension
• D. Projectile vomiting and altered electrolytes

Correct answer: C

Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.

5. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)

• A. Rash
• B. Urticaria
• C. All are applicable
• D. Photosensitivity

Correct answer: C

Rationale: Trimethoprim-sulfamethoxazole (Bactrim) can cause side effects like rash, urticaria, and photosensitivity. Parents and the child should be educated on these potential side effects to ensure prompt recognition and management.

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