Nokea
A child is brought into the ED with suspected appendicitis.
- A. Left lower quadrant pain
- B. Guarding
- C. Rebound tenderness
- D. Decreased C-reactive protein
- E. Pain on lifting thigh when supine
Correct Answer: B,C,E
Rationale: Guarding, rebound tenderness, and pain on thigh lifting are signs of appendicitis; pain is in the right lower quadrant, and C-reactive protein is elevated.
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What does the nurse expect this child to receive following gastric lavage?
- A. Activated charcoal
- B. N-Acetylcysteine
- C. Vitamin K
- D. Syrup of ipecac
Correct Answer: B
Rationale: N-Acetylcysteine is the antidote for acetaminophen poisoning, administered after gastric lavage.
What condition, will the nurse explain, is present causing this diagnosis?
- A. The yolk sac remains connected to the intestine.
- B. There is inflammation of the ileocecal valve.
- C. A pouch forms when the vitelline duct fails to disappear.
- D. There is a weakness in the abdominal wall.
Correct Answer: C
Rationale: Meckel's diverticulum results from the failure of the vitelline duct to disappear, forming a blind pouch.
What is the most appropriate action?
- A. Induce vomiting by giving the child syrup of ipecac.
- B. Take the child to the local emergency department.
- C. Give the child activated charcoal mixed with juice.
- D. Give the child milk to soothe affected mucous membranes.
Correct Answer: B
Rationale: Taking the child to the emergency department with the ingested substance's packaging is the safest action for dishwashing detergent ingestion.
What would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive?
- A. Cry to be picked up
- B. Be limp like a rag doll
- C. Be responsive to cuddling
- D. Weigh in the 10th percentile for age
Correct Answer: B
Rationale: Rag-doll limpness (hypotonia) is a characteristic finding in nonorganic failure to thrive, often with wariness of caregivers.
What is the most appropriate nursing action?
- A. Delay feeding the child for 6 hours.
- B. Offer regular formula thinned with water.
- C. Give small amounts of regular formula thickened with cereal.
- D. Allow 1 ounce of glucose water at frequent intervals.
Correct Answer: D
Rationale: Small, frequent glucose water feedings post-pyloric stenosis surgery support recovery while minimizing vomiting risk.