Nursing Elites

1. 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.

2. How should the nurse manage a child with acute lymphoblastic leukemia (ALL) who is receiving chemotherapy?

• A. Avoid all physical activity
• B. Ensure strict infection control measures
• C. Increase daily caloric intake
• D. Limit fluid intake

Correct answer: B

Rationale: The correct answer is B: Ensure strict infection control measures. Children with acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy have compromised immune systems, making them highly susceptible to infections. Implementing strict infection control measures, such as hand hygiene, limiting exposure to sick individuals, and maintaining a clean environment, is essential to prevent infections. Choice A is incorrect because avoiding all physical activity may not be necessary as long as the child's activity level is appropriate. Choice C is incorrect because increasing daily caloric intake is important to support the child's nutritional needs during treatment. Choice D is incorrect because limiting fluid intake is not typically recommended unless specifically advised by the healthcare provider.

3. How should a caregiver manage a child with a new diagnosis of sickle cell anemia?

• A. Ensure the child receives frequent blood transfusions
• B. Promote adequate hydration and pain management
• C. Restrict physical activity
• D. Administer high doses of vitamin C

Correct answer: B

Rationale: Promoting adequate hydration and pain management is crucial for managing sickle cell anemia to prevent crises and complications. Adequate hydration helps prevent sickling of red blood cells, while effective pain management is essential for addressing the frequent pain episodes associated with the condition. Ensuring the child receives frequent blood transfusions is not the initial management for sickle cell anemia; transfusions are usually reserved for specific complications. Restricting physical activity should be individualized based on the child's condition; some physical activity is beneficial for overall health. Administering high doses of vitamin C is not a standard treatment for sickle cell anemia and does not address the underlying pathology of the disease.

4. What is a common early sign of RSV (respiratory syncytial virus) in infants?

• A. High fever
• B. Nasal congestion
• C. Rash
• D. Jaundice

Correct answer: B

Rationale: Nasal congestion is a common early sign of RSV in infants, often accompanied by cough and wheezing. High fever, rash, and jaundice are not typically associated with RSV. While RSV can lead to fever, it is usually not one of the earliest signs. Rash and jaundice are unrelated to RSV symptoms.

5. How should the healthcare provider respond to a parent concerned about a child's short stature?

• A. Suggest the parent consult a nutritionist
• B. Recommend frequent growth hormone injections
• C. Advise monitoring for a few years before intervention
• D. Refer for a genetic evaluation

Correct answer: C

Rationale: When a parent expresses concern about a child's short stature, the initial approach should involve advising monitoring for a few years before considering any interventions. This allows for observation of the child's growth pattern and any potential underlying issues. Suggesting a nutritionist (Choice A) may not be necessary if there are no signs of nutritional deficiencies. Recommending growth hormone injections (Choice B) is premature without proper evaluation and diagnosis. Referring for a genetic evaluation (Choice D) can be considered later if monitoring shows atypical growth patterns or other concerning factors.

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