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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 most common cause of acute kidney injury in children?
- A. Dehydration
- B. Glomerulonephritis
- C. Hemolytic uremic syndrome
- D. Sepsis
Correct Answer: C
Rationale: Hemolytic uremic syndrome is the most common cause of acute kidney injury in children. While dehydration can lead to prerenal acute kidney injury, it is not the most common cause in children. Glomerulonephritis is a common cause of chronic kidney disease but not typically the most common cause of acute kidney injury in children. Sepsis can lead to acute kidney injury, but in children, hemolytic uremic syndrome is more prevalent.
What component should be included in the nutritional management of a child with Crohn's disease?
- A. High fiber
- B. Increased protein
- C. Reduced calories
- D. Herbal supplements
Correct Answer: B
Rationale: The correct answer is B: Increased protein. Children with Crohn's disease require a diet high in protein to support growth and tissue repair. High fiber should be avoided as it can exacerbate symptoms of Crohn's disease. Reducing calories can lead to malnutrition, which is detrimental in this condition. Herbal supplements should be used cautiously and only under medical advice as they may interact with medications or worsen symptoms.
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.
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.
After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?
- A. Notify the healthcare provider.
- B. Insert a new NG tube for feedings.
- C. Replace the NG tube to maintain gastric decompression.
- D. Leave the NG tube out as it may have been in long enough.
Correct Answer: A
Rationale: The most appropriate action for the nurse to take in this situation is to notify the healthcare provider immediately. This is important as the removal of the NG tube can disrupt postoperative care, especially in terms of maintaining gastric decompression. Inserting a new NG tube without practitioner direction can be unsafe and is not within the nurse's scope of practice. Similarly, replacing the NG tube or leaving it out should be decided by the healthcare provider to ensure the infant's safety and appropriate postoperative care.