Nokea
Which of the following is the best indicator of a child's nutritional status?
- A. Weight
- B. Height
- C. Head circumference
- D. Mid-upper arm circumference
Correct Answer: D
Rationale: Mid-upper arm circumference is a good indicator of muscle mass and fat stores, reflecting a child's nutritional status. It is particularly useful in assessing malnutrition, as it is less affected by fluid retention or dehydration compared to other anthropometric measurements. Weight can fluctuate due to factors like hydration status, making it less reliable as a sole indicator of nutritional status. Height reflects growth but may not directly indicate current nutritional status. Head circumference is more related to brain growth and development rather than overall nutritional status.
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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.
What is the primary treatment goal for a child with juvenile idiopathic arthritis?
- A. Pain management
- B. Cure of the disease
- C. Reduction of joint deformity
- D. Physical therapy
Correct Answer: A
Rationale: The primary treatment goal for a child with juvenile idiopathic arthritis is pain management. Juvenile idiopathic arthritis is a chronic condition with no known cure, making pain management crucial to improve the quality of life for these children. While reducing joint deformity and physical therapy are important aspects of managing the condition, the primary focus is on alleviating pain and improving function.
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.
What is often the initial sign of acute rheumatic fever in children?
- A. Polyarthritis
- B. Carditis
- C. Erythema marginatum
- D. Sydenham chorea
Correct Answer: A
Rationale: Polyarthritis is indeed frequently the initial sign of acute rheumatic fever in children. It presents as joint pain, swelling, and redness. Carditis (inflammation of the heart), Erythema marginatum (a skin rash), and Sydenham chorea (involuntary muscle movements) are typically seen in the later stages of acute rheumatic fever and not as the initial sign.
What is the recommended position for a child with epiglottitis to ease breathing?
- A. Supine
- B. Prone
- C. Tripod
- D. Semi-Fowler's
Correct Answer: C
Rationale: The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler's) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler's position do not facilitate optimal air exchange in these cases.