Nokea
What is the best indicator of fluid balance in a pediatric patient?
- A. Blood pressure
- B. Heart rate
- C. Weight
- D. Urine output
Correct Answer: C
Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.
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Which pediatric condition is characterized by a "string sign" on an upper GI series?
- A. Intussusception
- B. Hypertrophic pyloric stenosis
- C. Hirschsprung disease
- D. Meckel diverticulum
Correct Answer: B
Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.
Melena, the passage of black, tarry stools, suggests bleeding from which source?
- A. The perianal or rectal area
- B. The upper gastrointestinal (GI) tract
- C. The lower GI tract
- D. Hemorrhoids or anal fissures
Correct Answer: B
Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.
The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?
- A. Advise bed rest until 1 week after the icteric phase.
- B. Teach infection control measures to family members.
- C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
- D. Reassure the mother that hepatitis A cannot be transmitted to other family members.
Correct Answer: B
Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.
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.
In children with Type 1 diabetes, what is a common early sign of hypoglycemia?
- A. Irritability
- B. Rapid heartbeat
- C. Confusion
- D. Sweating
Correct Answer: D
Rationale: Sweating is indeed one of the earliest signs of hypoglycemia in children with Type 1 diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can lead to sweating. While irritability, rapid heartbeat, and confusion can also be seen in hypoglycemia, sweating is particularly common as a quick indicator of low blood sugar levels in children with Type 1 diabetes.