Nokea
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 term describes the invagination of one segment of bowel within another?
- A. Atresia
- B. Stenosis
- C. Herniation
- D. Intussusception
Correct Answer: D
Rationale: Intussusception is the correct answer. It refers to the condition where one segment of the bowel folds into another, leading to an obstruction. Atresia (Choice A) is the absence or abnormal closure of a normal opening or tubular structure. Stenosis (Choice B) is the narrowing of a passage in the body. Herniation (Choice C) is the abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Intussusception is a medical emergency commonly observed in infants and young children and necessitates prompt intervention to prevent severe complications.
What is a key distinguishing feature of bronchiolitis in infants?
- A. Dry cough
- B. Wheezing
- C. Stridor
- D. Productive cough
Correct Answer: B
Rationale: The correct answer is B: Wheezing. Wheezing is a key distinguishing feature of bronchiolitis in infants, typically caused by respiratory syncytial virus (RSV) infection. Bronchiolitis is characterized by inflammation and mucus buildup in the small airways of the lungs, leading to wheezing sounds during breathing. Choices A, C, and D are incorrect because dry cough, stridor, and productive cough are not typical features of bronchiolitis in infants.
When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?
- A. At bedtime
- B. With a meal
- C. Midmorning
- D. 30 minutes before breakfast
Correct Answer: D
Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.
The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe?
- A. Steatorrhea
- B. All are correct
- C. Malnutrition
- D. Foul-smelling stools
Correct Answer: B
Rationale: Celiac disease often presents with steatorrhea, malnutrition, and foul-smelling stools due to the malabsorption of nutrients. Therefore, all the manifestations listed (steatorrhea, malnutrition, foul-smelling stools) are expected in a child with celiac disease. Polycythemia is not associated with celiac disease, making choice B the correct answer.
What should the healthcare provider consider when providing support to a family whose infant has just been diagnosed with biliary atresia?
- A. The prognosis for full recovery is excellent.
- B. Death usually occurs by 6 months of age.
- C. Liver transplantation may be needed eventually.
- D. Children with surgical correction live normal lives.
Correct Answer: C
Rationale: When supporting a family whose infant has been diagnosed with biliary atresia, it is important to consider that liver transplantation may be needed eventually. Biliary atresia is a serious condition where bile flow from the liver to the gallbladder is blocked or absent. While surgical interventions like the Kasai procedure can temporarily improve bile flow and delay the need for transplantation, the long-term survival often depends on liver transplantation as the child grows older. Choices A, B, and D are incorrect because the prognosis for full recovery is not excellent as biliary atresia is a chronic condition that often requires ongoing medical management, death usually does not occur by 6 months of age but the condition does require intervention, and not all children with surgical correction can live normal lives without the need for further interventions like transplantation.