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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.
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The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize?
- A. The onset is rapid.
- B. Fever occurs early.
- C. All are applicable
- D. Nausea and vomiting are common.
Correct Answer: C
Rationale: The correct answer is C. Hepatitis A typically presents with a rapid onset, early fever, and nausea/vomiting. These are common clinical features seen in patients with hepatitis A. A pruritic rash is not commonly associated with hepatitis A, so choice C is incorrect. Choice A and B alone are not sufficient to cover all the clinical features of hepatitis A.
What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?
- A. The medication reduces gastric acid secretion.
- B. The medication neutralizes the acid in the stomach.
- C. The medication increases the rate of gastric emptying time.
- D. The medication coats the lining of the stomach and esophagus.
Correct Answer: A
Rationale: The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.
The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?
- A. Initiating breast or bottle-feedings to stabilize the blood glucose level
- B. Maintaining pain management with an intravenous opioid
- C. Covering the intact bowel with a nonadherent dressing to prevent injury
- D. Performing immediate surgery
Correct Answer: C
Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.
What is the best indicator of fluid balance in a pediatric patient?
- A. Blood pressure
- B. Heart rate
- C. Weight
- D. Urine output
Correct Answer: C
Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.
What dietary modification is recommended for a child with cystic fibrosis?
- A. High carbohydrate
- B. Low protein
- C. High calorie
- D. Low fat
Correct Answer: C
Rationale: A high-calorie diet is recommended for children with cystic fibrosis due to their increased energy needs and malabsorption issues. Cystic fibrosis affects the pancreas, leading to poor digestion and absorption of nutrients, particularly fats, which requires dietary adjustments to maintain adequate nutrition. High carbohydrate (Choice A) is not the primary focus; the emphasis is on overall calorie intake. Low protein (Choice B) is not recommended as protein intake is essential for growth and development. Low fat (Choice D) is not the best option as fat-soluble vitamin absorption is already compromised in cystic fibrosis, hence fat restriction is not a priority.