Nokea
An emergency department nurse is performing an assessment on a child with a suspected diagnosis of intussusception. Which assessment question for the parents will elicit the most specific data related to this disorder?
- A. Does the child have any food allergies?
- B. What do the bowel movements look like?
- C. Has the child eaten any food in the last 24 hours?
- D. Can you describe the type of pain that the child is experiencing?
Correct Answer: D
Rationale: The correct answer is asking the parents to describe the type of pain the child is experiencing because a report of severe colicky abdominal pain in a healthy, thriving child between 3 and 17 months of age is the classic presentation of intussusception. Typical behavior includes screaming and drawing the knees up to the chest. This specific question helps in identifying the key symptom of intussusception. Choices A, B, and C are important aspects of a health history but are not specific to the diagnosis of intussusception. Food allergies, bowel movements, and recent food intake are relevant for a comprehensive assessment but do not directly relate to the specific symptoms of intussusception.
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A home care nurse instructs the mother of a 5-year-old child with lactose intolerance about dietary measures for her child. The nurse should tell the mother that it is necessary to provide which dietary supplement in the child's diet?
- A. Fats
- B. Zinc
- C. Protein
- D. Calcium
Correct Answer: D
Rationale: In lactose intolerance, the inability to digest lactose, the sugar in dairy products, can lead to calcium deficiency if dairy products are removed from the diet. Calcium is crucial for bone health and other bodily functions, so alternative calcium sources like fortified non-dairy milks or leafy greens must be included to prevent deficiency. While fats and proteins are important nutrients, they are not typically deficient in lactose intolerance. Zinc, although an essential mineral, is not the primary concern in this case.
In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation?
- A. Polyphagia
- B. Dehydration
- C. Bedwetting
- D. Weight loss
Correct Answer: C
Rationale: The correct answer is 'Bedwetting.' One of the initial symptoms of type 1 diabetes in children is bedwetting. Parents are likely to notice bedwetting in a school-age child, prompting them to seek evaluation. Polyphagia (excessive hunger) and weight loss are also common symptoms of diabetes but may not be as readily noticeable to parents compared to bedwetting. Dehydration is a consequence of diabetes rather than an early symptom that would prompt parents for evaluation.
What is the most appropriate suggestion regarding the diet for an 18-month-old child experiencing mild diarrhea and 'mushy' stools, but tolerating fluids and solid foods?
- A. Applesauce, bananas, wheat toast
- B. Mashed potatoes with baked chicken
- C. Gelatin, strained cabbage, and custard
- D. Fluids only until the 'mushy' stools stop
Correct Answer: B
Rationale: For a child with mild diarrhea who is tolerating fluids and solid foods, the most appropriate diet suggestion would be to continue feeding a normal diet to prevent dehydration, reduce stool frequency and volume, and hasten recovery. Foods that are well tolerated during diarrhea include bland but nutritional options like complex carbohydrates (rice, wheat, potatoes, cereals), yogurt with live cultures, cooked vegetables, and lean meats. Mashed potatoes with baked chicken provide a balance of nutrients and are easy on the digestive system. Options A and C contain foods that may worsen diarrhea; applesauce and gelatin can be high in sugars which can exacerbate diarrhea, and cabbage may be hard to digest for some individuals. Option D of offering fluids only can affect the child's nutritional status by not providing enough essential nutrients during the recovery period.
A child is diagnosed with a Greenstick Fracture. Which of the following most accurately describes the broken bone?
- A. compound fracture of the fibula
- B. a partial break in a long bone
- C. fracture of the growth plate of the ulna near the wrist
- D. Colles fracture of the tibia
Correct Answer: B
Rationale: A Greenstick Fracture is commonly found in children due to their bones being more flexible. This type of fracture occurs when a bone bends and partially breaks, resembling what happens when a green stick from a tree is bent in half. Therefore, the most accurate description of a Greenstick Fracture is 'a partial break in a long bone.' Choice A, 'compound fracture of the fibula,' is incorrect as a Greenstick Fracture is not a compound fracture. Choice C, 'fracture of the growth plate of the ulna near the wrist,' is incorrect as it describes a different type of fracture. Choice D, 'Colles fracture of the tibia,' is incorrect as it refers to a specific type of fracture in a different bone.
Signs and symptoms of stroke may include all of the following EXCEPT:
- A. Sudden weakness or numbness of the face, arm, or leg.
- B. Sudden confusion.
- C. Sudden headache with no known cause.
- D. Hypotension.
Correct Answer: D
Rationale: Hypotension is not a typical sign or symptom of an acute stroke. The correct signs and symptoms of a stroke include sudden weakness or numbness of the face, arm, or leg, sudden confusion, and a sudden headache with no known cause. Hypotension, which refers to low blood pressure, is not a common indicator of a stroke. It is important to differentiate between hypotension and hypertension in the context of stroke symptoms, as hypertension (high blood pressure) is actually a risk factor for strokes. Sudden weakness, numbness, confusion, and headache are signs associated with a stroke due to a disruption in blood flow to the brain. Hypotension, on the other hand, primarily indicates low blood pressure and is not directly linked to the typical presentation of a stroke.