Nursing Elites

1. When caring for a child diagnosed with sickle cell anemia, what is the priority nursing intervention?

• A. Administering pain medication
• B. Ensuring adequate hydration
• C. Providing nutritional support
• D. Monitoring vital signs

Correct answer: A

Rationale: The priority nursing intervention when caring for a child with sickle cell anemia is administering pain medication. Pain management is crucial in sickle cell anemia due to vaso-occlusive crises that can cause severe pain. While ensuring adequate hydration, providing nutritional support, and monitoring vital signs are important aspects of care for a child with sickle cell anemia, addressing the pain with appropriate medication takes precedence to alleviate the child's suffering and improve their quality of life.

2. One principle to be followed for children with type 1 diabetes is to provide for the variability of the child’s activity. What should the nurse teach the child about how to compensate for increased physical activity?

• A. Eat more food when planning to exercise more than usual.
• B. Take oral, not injectable insulin, on days of heavy exercise.
• C. Take insulin in the morning when extra exercise is anticipated.
• D. Eat foods that contain sugar to compensate for the extra exercise.

Correct answer: A

Rationale: The correct answer is to eat more food when planning to exercise more than usual. Increased physical activity requires more energy, so additional food intake is necessary to compensate for the increased energy expenditure. This helps maintain blood sugar levels within the target range. Choice B is incorrect because the mode of insulin administration does not change based on physical activity; the type and dose of insulin remain the same unless adjusted by a healthcare provider. Choice C is incorrect because insulin timing should not be adjusted solely based on anticipated exercise; consistent timing of insulin doses is crucial for stable blood sugar control. Choice D is incorrect because consuming foods with sugar may lead to unstable blood sugar levels and is not the recommended way to compensate for extra exercise, as it can result in sudden spikes and drops in blood glucose levels, affecting overall diabetes management.

3. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: B

Rationale: The correct dietary instruction for a 2-year-old child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye that can worsen GERD symptoms. Avoiding gluten can help reduce inflammation and discomfort in the esophagus. Choices A, C, and D are incorrect because spicy foods, high-fat foods, and dairy products can exacerbate GERD symptoms. Spicy foods can irritate the esophagus, high-fat foods delay stomach emptying leading to increased acid reflux, and dairy products can stimulate acid production, all of which can worsen GERD symptoms.

4. Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

• A. pulmonary infection
• B. right-to-left shunt of blood
• C. decreased workload on the left side of the heart
• D. increased pulmonary vascular congestion

Correct answer: D

Rationale: Surgical repair of patent ductus arteriosus (PDA) aims to prevent increased pulmonary vascular congestion, which can lead to congestive heart failure and respiratory distress. Choice A, pulmonary infection, is not a direct complication of PDA but rather a result of other factors. Choice B, right-to-left shunt of blood, is a characteristic of a different heart condition (e.g., Tetralogy of Fallot) and not specifically associated with PDA. Choice C, decreased workload on the left side of the heart, is not a typical complication of PDA but rather a consequence of left-to-right shunting that can cause volume overload in the pulmonary circulation.

5. A parent tells a nurse at the clinic, 'Each morning I offer my 24-month-old child juice, and all I hear is ‘No.’ What should I do because I know my child needs fluid?' What strategy should the nurse suggest?

• A. Offer the child a choice of two juices.
• B. Distract the child with a favorite food.
• C. Offer the child the glass in a firm manner.
• D. Allow the child to see the parent getting angry.

Correct answer: A

Rationale: Offering a choice between two options allows the child to feel a sense of control while ensuring they get the necessary fluids. Providing a choice empowers the child and increases the likelihood of cooperation. Distracting the child with food or offering the glass in a firm manner may not address the underlying issue of refusal. Allowing the child to witness the parent's anger can create a negative environment and may not help in resolving the situation positively.

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