Nursing Elites

1. How should a healthcare provider address the nutritional needs of a child with chronic kidney disease?

• A. Increase protein intake
• B. Reduce sodium and phosphorus intake
• C. Promote a high-fat diet
• D. Encourage frequent sugary snacks

Correct answer: B

Rationale: Reducing sodium and phosphorus intake is crucial in managing chronic kidney disease in children because it helps prevent complications such as electrolyte imbalances and bone problems. High protein intake can actually be harmful to the kidneys in this condition as it can lead to increased waste production. A high-fat diet is not recommended as it can contribute to heart and blood vessel problems. Encouraging frequent sugary snacks can lead to further complications like obesity and diabetes, which are not beneficial for a child with chronic kidney disease.

2. What should be a priority for a 4-year-old child with nephrosis?

• A. Impaired body image
• B. Skin impairment
• C. Nutritional deficit
• D. Injury

Correct answer: B

Rationale: The correct answer is B: Skin impairment. Skin care is a priority in nephrosis due to edema and increased risk of skin breakdown, requiring careful monitoring and management. While impaired body image (Choice A) can be a concern, it is not typically a priority in a 4-year-old with nephrosis. Nutritional deficit (Choice C) is important but addressing skin impairment takes precedence due to the immediate risk of complications related to skin breakdown. Injury (Choice D) is a general concern for children but is not the priority in a child with nephrosis.

3. How much energy is required to raise the temperature of one kilogram of water by 1°C?

• A. 10 calories
• B. 100 calories
• C. 1 kilocalorie
• D. 10 kilocalories

Correct answer: C

Rationale: The correct answer is 1 kilocalorie. This is the amount of energy required to raise the temperature of 1 kilogram of water by 1°C. Choice A (10 calories) and Choice D (10 kilocalories) are incorrect as they do not represent the correct unit of measurement for this specific scenario. Choice B (100 calories) is also incorrect as it overestimates the amount of energy required. The specific heat capacity of water is approximately 1 calorie/gram °C, which means that 1 kilogram (1000 grams) of water requires 1 kilocalorie (1000 calories) to raise its temperature by 1°C.

4. Parents of a 6-month-old child, diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What should the nurse say?

• A. Are you sure your child has iron deficiency anemia?
• B. Maternal stores of iron are depleted at about 6 months.
• C. This anemia is caused by blood loss.
• D. The child may not have had it for a long time.

Correct answer: B

Rationale: The correct answer is B: 'Maternal stores of iron are depleted at about 6 months.' Iron deficiency anemia becomes apparent around 6 months of age when the infant's iron stores, primarily received from the mother during pregnancy, are depleted. This timing coincides with the introduction of solid foods, which may lack sufficient iron. Choices A, C, and D are incorrect because they do not address the specific reason why iron deficiency anemia is typically diagnosed around 6 months of age.

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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