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What is the most appropriate intervention for a child with suspected acute appendicitis?
- A. Administer antibiotics
- B. Apply heat to the abdomen
- C. Encourage oral fluids
- D. Prepare for surgery
Correct Answer: D
Rationale: The correct answer is D: Prepare for surgery. Acute appendicitis is a surgical emergency that requires prompt removal of the appendix to prevent complications like rupture and peritonitis. Administering antibiotics (choice A) may be part of the treatment plan but should not delay surgical intervention. Applying heat to the abdomen (choice B) is not recommended as it can worsen the inflammation of the appendix. Encouraging oral fluids (choice C) is generally beneficial, but the priority in acute appendicitis is surgical intervention.
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What is the typical presentation of pyloric stenosis in infants?
- A. Bilious vomiting
- B. Projectile vomiting
- C. Blood in stools
- D. Failure to thrive
Correct Answer: B
Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.
What is the most important intervention in the management of a child with sickle cell crisis?
- A. Administration of iron supplements
- B. Initiation of high-calorie diet
- C. Administration of pain relief
- D. Limiting fluid intake
Correct Answer: C
Rationale: The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications.
Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis.
Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis.
Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.
The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?
- A. Spitting up
- B. Bilious vomiting
- C. Failure to thrive
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.
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.
The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?
- A. Pain is common.
- B. Weight loss is severe.
- C. All are correct.
- D. Diarrhea is moderate to severe.
Correct Answer: C
Rationale: The correct answer is C because Crohn's disease commonly presents with pain, severe weight loss, and moderate to severe diarrhea in affected individuals. Therefore, all the manifestations listed are typically observed in patients with Crohn's disease. Choice A alone is not sufficient as weight loss and diarrhea are also prominent symptoms. Choice B is incorrect as it only mentions weight loss, omitting other common manifestations. Choice D is also incorrect as it does not cover the full range of expected clinical signs in Crohn's disease.