Nokea
The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include?
- A. Keep the tube clamped.
- B. Suction the tube as needed.
- C. Leave the tube open to gravity drainage.
- D. Secure the tube with tape.
Correct Answer: C
Rationale: Leaving the gastrostomy tube open to gravity drainage prevents the accumulation of air and fluids, reducing the risk of complications such as vomiting or aspiration in the immediate postoperative period. Keeping the tube clamped or suctioning it can lead to pressure buildup, increasing the risk of complications. Securing the tube with tape is important but not the primary action related to the gastrostomy tube in this case.
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Which electrolyte imbalance is a common concern in children with severe diarrhea?
- A. Hypernatremia
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypomagnesemia
Correct Answer: B
Rationale: Hypokalemia is the correct answer because it is a common concern in children with severe diarrhea. Diarrhea can lead to significant potassium loss, resulting in hypokalemia. Hypernatremia (Choice A) is less common in diarrhea as sodium concentration is usually diluted by the fluid loss. Hypercalcemia (Choice C) is not typically associated with severe diarrhea. Hypomagnesemia (Choice D) can occur but is not as common as hypokalemia in this scenario.
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 the recommended position for a child with epiglottitis to ease breathing?
- A. Supine
- B. Prone
- C. Tripod
- D. Semi-Fowler's
Correct Answer: C
Rationale: The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler's) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler's position do not facilitate optimal air exchange in these cases.
What is the therapeutic intervention that provides the best chance of survival for a child with cirrhosis?
- A. Nutritional support
- B. Liver transplantation
- C. Blood component therapy
- D. Treatment with corticosteroids
Correct Answer: B
Rationale: Liver transplantation offers the best chance of survival for children with cirrhosis, especially in advanced stages where the liver can no longer function effectively. Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. While nutritional support, blood component therapy, and corticosteroids may be part of the treatment plan to manage symptoms and complications, they do not address the underlying cause of cirrhosis or provide a cure like liver transplantation does.
Which factor is most likely to cause a "brittle" diabetic state in a child with type 1 diabetes?
- A. Noncompliance with diet
- B. Insulin resistance
- C. Frequent infections
- D. Hypothyroidism
Correct Answer: C
Rationale: Frequent infections can destabilize blood sugar levels, leading to a "brittle" diabetic state in children with type 1 diabetes. Infections increase metabolic demands and can result in significant blood glucose fluctuations, requiring careful monitoring and adjustment of insulin therapy. Noncompliance with diet may affect blood sugar control but is not the primary cause of a "brittle" state. Insulin resistance is more common in type 2 diabetes rather than type 1. Hypothyroidism can impact metabolism but is not directly linked to the development of a "brittle" diabetic state in type 1 diabetes.