Nokea
A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock?
- A. Restlessness
- B. Rapid capillary refill
- C. Increased temperature
- D. Increased blood pressure
Correct Answer: A
Rationale: Restlessness is an early sign of shock due to decreased perfusion and oxygenation to the brain. This symptom requires immediate attention to prevent the progression to more severe stages of shock. Rapid capillary refill (Choice B) is not typically an early sign of shock but rather a sign of adequate perfusion. Increased temperature (Choice C) may occur in later stages of shock due to the body's response to stress. Increased blood pressure (Choice D) is not an early sign of shock; in fact, blood pressure tends to decrease in shock as a compensatory mechanism.
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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.
What is the most appropriate action for a child with epistaxis?
- A. Have the child lie flat
- B. Pinch the nose and lean forward
- C. Apply a warm compress to the nose
- D. Encourage deep breathing
Correct Answer: B
Rationale: The most appropriate action for a child with epistaxis is to pinch the nose and lean forward. This technique helps stop the bleeding and prevent aspiration of blood. By applying pressure to the bleeding vessels and allowing the blood to drain out of the nostrils instead of being swallowed, the risk of nausea and airway obstruction is reduced. Having the child lie flat (Choice A) may lead to blood flowing down the throat, causing potential choking. Applying a warm compress (Choice C) is not typically recommended for epistaxis as cold compresses are more effective. Encouraging deep breathing (Choice D) is not directly related to managing epistaxis.
What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?
- A. The medication reduces gastric acid secretion.
- B. The medication neutralizes the acid in the stomach.
- C. The medication increases the rate of gastric emptying time.
- D. The medication coats the lining of the stomach and esophagus.
Correct Answer: A
Rationale: The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.
Which condition is characterized by a 'seal-like' barking cough in children?
- A. Croup
- B. Asthma
- C. Bronchitis
- D. Pneumonia
Correct Answer: A
Rationale: Croup is the correct answer. Croup is characterized by a 'seal-like' barking cough due to inflammation and narrowing of the upper airways, particularly the larynx and trachea. It is most common in young children and can cause significant respiratory distress, especially at night. Treatment often includes humidified air and corticosteroids. Asthma (choice B) typically presents with wheezing and shortness of breath, not a barking cough. Bronchitis (choice C) is characterized by productive cough with mucus, not a barking cough. Pneumonia (choice D) often presents with fever, productive cough, and chest pain, not a barking cough.
What is a classic sign of congenital hypothyroidism in newborns?
- A. Jaundice
- B. Hypothermia
- C. Prolonged jaundice
- D. Excessive crying
Correct Answer: C
Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.