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What intervention is contraindicated in a suspected case of appendicitis?
- A. Enemas
- B. Palpating the abdomen
- C. Administration of antibiotics
- D. Administration of antipyretics for fever
Correct Answer: A
Rationale: Enemas are contraindicated in cases of suspected appendicitis because they can increase the risk of perforation. The pressure from the enema can exacerbate inflammation and potentially lead to the rupture of the appendix. Palpating the abdomen gently is essential for diagnosing appendicitis, as it helps identify the characteristic signs like rebound tenderness. Antibiotics are commonly used to treat the infection associated with appendicitis, and antipyretics are administered to manage fever, which is a common symptom of the condition. Therefore, enemas are the intervention to avoid in suspected appendicitis cases.
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What is typically the first sign of puberty in females?
- A. Breast development
- B. Menarche
- C. Pubic hair growth
- D. Axillary hair growth
Correct Answer: A
Rationale: The correct answer is A: Breast development (thelarche) is usually the first sign of puberty in females, typically beginning between ages 8 and 13. This marks the start of puberty, followed by pubic hair growth, a growth spurt, and eventually menarche (the onset of menstruation). Pubic hair growth and axillary hair growth usually follow breast development in the sequence of pubertal changes. Therefore, the first noticeable change indicating the onset of puberty in females is the development of breast buds.
When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?
- A. Anorexia
- B. Bradycardia
- C. Sudden relief from pain
- D. Decreased abdominal distention
Correct Answer: C
Rationale: When caring for a child with probable appendicitis, sudden relief from pain is a critical sign that could indicate perforation of the appendix. Perforation results in the release of pressure and inflammation, leading to a temporary relief of pain. Anorexia (loss of appetite) and decreased abdominal distention are symptoms commonly associated with appendicitis itself, not perforation. Bradycardia (slow heart rate) is not typically a direct manifestation of appendicitis or its complications.
What disease should be suspected in a 3-day-old infant presenting with abdominal distention, vomiting, and failure to pass meconium?
- A. Pyloric stenosis
- B. Intussusception
- C. Hirschsprung disease
- D. Celiac disease
Correct Answer: C
Rationale: Hirschsprung disease should be suspected in a newborn with abdominal distention, vomiting, and failure to pass meconium. This condition arises from a congenital absence of nerve cells in a portion of the colon, leading to severe constipation and intestinal obstruction. Pyloric stenosis typically presents with non-bilious projectile vomiting in the first few weeks of life. Intussusception classically manifests with sudden onset of colicky abdominal pain and currant jelly stools. Celiac disease may present with chronic diarrhea, failure to thrive, and abdominal distention but is less likely in this scenario.
Which vaccine is contraindicated in a child with a history of severe egg allergy?
- A. MMR
- B. Varicella
- C. Influenza
- D. Hepatitis B
Correct Answer: C
Rationale: The correct answer is C: Influenza. The influenza vaccine is produced using egg-based technology, so individuals with a severe egg allergy are at risk of an allergic reaction if vaccinated with the influenza vaccine. This is due to the potential presence of egg proteins in the vaccine. Choices A, B, and D are not contraindicated in children with severe egg allergy. The MMR and Varicella vaccines do not pose a risk for children with egg allergies, and the Hepatitis B vaccine is also safe for these individuals.
The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?
- A. Citrus
- B. All of the above
- C. Spicy foods
- D. Peppermint
Correct Answer: B
Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.