Nokea
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.
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The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?
- A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
- B. Hold the infant in the prone position after a feeding.
- C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
- D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.
Correct Answer: D
Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.
The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?
- A. Citrus
- B. All of the above
- C. Spicy foods
- D. Peppermint
Correct Answer: B
Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.
What is the most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants?
- A. Gastroesophageal reflux
- B. Respiratory distress
- C. Stricture formation
- D. Aspiration pneumonia
Correct Answer: C
Rationale: The most common complication following surgical correction of esophageal atresia with tracheoesophageal fistula in infants is stricture formation. This complication occurs due to the healing process after surgery, leading to the narrowing of the esophagus. Gastroesophageal reflux (Choice A) can be a concern but is not the most common complication. Respiratory distress (Choice B) may happen but is not the primary complication. Aspiration pneumonia (Choice D) is a risk but is typically not as common as stricture formation in these cases.
Which condition is most commonly associated with a 'sunset sign' in infants?
- A. Hydrocephalus
- B. Meningitis
- C. Cerebral palsy
- D. Encephalitis
Correct Answer: A
Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'
What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis?
- A. Bruising and lethargy
- B. Anorexia and malaise
- C. Fatigability and jaundice
- D. Dark urine and pale stools
Correct Answer: B
Rationale: The correct answer is B: Anorexia and malaise. The prodromal phase of acute viral hepatitis is characterized by nonspecific symptoms such as anorexia (loss of appetite) and malaise (general feeling of discomfort). These symptoms typically precede the more specific signs of jaundice, dark urine, and pale stools that manifest in the icteric phase. Choices A, C, and D are incorrect because bruising and lethargy, fatigability and jaundice, and dark urine and pale stools are typically seen in later stages of acute viral hepatitis, not in the prodromal phase.