Nursing Elites

1. Gram for gram, which class of nutrient provides the most energy?

• A. fats
• B. alcohols
• C. proteins
• D. carbohydrates

Correct answer: A

Rationale: The correct answer is fats. Fats provide 9 kilocalories per gram, which is more energy-dense compared to proteins and carbohydrates. While proteins and carbohydrates provide 4 kilocalories per gram, fats provide more than twice the energy, making them the most energy-providing nutrient. Alcohols are not considered essential nutrients and do not provide energy for the body, unlike fats, proteins, and carbohydrates. Therefore, fats are the correct answer for the most energy-providing nutrient.

2. What is the recommended first step in the management of a child with a suspected head injury?

• A. Administer pain medication
• B. Assess the child's level of consciousness
• C. Perform a CT scan
• D. Monitor for seizures

Correct answer: B

Rationale: The correct first step in managing a child with a suspected head injury is to assess the child's level of consciousness. This assessment is crucial as it helps determine the severity of the injury and guides further management. Administering pain medication (Choice A) should not be done before assessing the level of consciousness. Performing a CT scan (Choice C) may be necessary but is not the initial step. Monitoring for seizures (Choice D) is important but comes after assessing the child's level of consciousness.

3. What is a key aspect of care for a child with an indwelling urinary catheter?

• A. Increase fluid intake
• B. Monitor for signs of infection
• C. Restrict mobility
• D. Administer daily antibiotics

Correct answer: B

Rationale: Monitoring for signs of infection is crucial when caring for a child with an indwelling urinary catheter. This is because catheter-associated urinary tract infections are common in such cases. Increasing fluid intake can be beneficial, but monitoring for infection takes precedence as it is crucial to prevent complications. Restricting mobility is not a key aspect of care for a child with an indwelling urinary catheter unless specifically advised by a healthcare provider. Administering daily antibiotics without proper assessment and indication can lead to antibiotic resistance and is not a standard practice in caring for a child with an indwelling urinary catheter.

4. How is gastroesophageal reflux (GER) typically treated in infants?

• A. Keeping the infant NPO
• B. Thickening the formula or breast milk with cereal
• C. Placing the infant to sleep on the side
• D. Switching the infant to cow's milk

Correct answer: B

Rationale: Thickening the formula or breast milk with cereal is a common treatment for gastroesophageal reflux (GER) in infants. By adding cereal, the feedings become heavier, making it less likely for the stomach contents to reflux. Keeping the infant NPO (nothing by mouth) is not typically necessary for GER treatment and might not be appropriate. Placing the infant to sleep on the side is not recommended due to the risk of sudden infant death syndrome (SIDS). Switching the infant to cow's milk is also not a recommended treatment for GER as it can exacerbate symptoms due to its protein content.

5. What action should be taken for a 2-year-old with laryngotracheobronchitis in an oxygen tent?

• A. Restrain the child and notify the healthcare provider
• B. Increase the oxygen concentration
• C. Take the child to the playroom
• D. Ask the mother to help in comforting the child

Correct answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

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