Nursing Elites

1. How should hydration status in a child with fever and vomiting be assessed?

• A. Monitor skin turgor and mucous membranes
• B. Measure blood glucose levels
• C. Check for signs of jaundice
• D. Assess respiratory rate

Correct answer: A

Rationale: To assess hydration status in a child with fever and vomiting, monitoring skin turgor and mucous membranes is essential. Skin turgor refers to the skin's ability to change shape and return to normal; poor skin turgor can indicate dehydration. Mucous membranes, such as the mouth and eyes, can also provide valuable information about hydration levels. Measuring blood glucose levels (Choice B) is not directly related to assessing hydration status. Checking for signs of jaundice (Choice C) is important for liver-related issues, not hydration assessment. Assessing respiratory rate (Choice D) is crucial for evaluating respiratory function, not hydration status.

2. By chemical analysis, what nutrient is present in the highest amounts in most foods?

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

Correct answer: B

Rationale: The correct answer is B. Water is the most abundant nutrient in many foods. Water content varies across different foods, but in general, it is present in the highest amounts. Fats (Choice A) are essential but are not found in higher amounts compared to water. Proteins (Choice C) and carbohydrates (Choice D) are also important nutrients, but they are typically found in lower quantities in most foods compared to water.

3. What should be included in the medical management of a sickle cell crisis?

• A. Information for parents on home care
• B. Adequate hydration and pain management
• C. Pain management and iron supplements
• D. Adequate oxygenation and factor VIII

Correct answer: B

Rationale: The correct answer is B: Adequate hydration and pain management. During a sickle cell crisis, it is essential to provide hydration to prevent vaso-occlusive events and manage pain effectively with analgesics. Adequate hydration helps maintain blood flow and prevent further sickling of red blood cells. Pain management is crucial to alleviate the severe pain associated with sickle cell crises. Options A, C, and D are incorrect. Providing information for parents on home care (Option A) may be important for ongoing management but is not specific to an acute crisis. Iron supplements (Option C) are not typically indicated during a sickle cell crisis. Adequate oxygenation and factor VIII (Option D) are not primary interventions for managing a sickle cell crisis; instead, oxygen therapy may be considered in severe cases, and factor VIII is not a standard treatment for sickle cell disease.

4. What is an important nursing intervention for a child with a newly inserted central venous catheter?

• A. Regularly monitor for signs of infection
• B. Administer intravenous fluids only as ordered
• C. Restrict the child's movement
• D. Perform daily dressing changes only

Correct answer: A

Rationale: Regularly monitoring for signs of infection is a critical nursing intervention for a child with a newly inserted central venous catheter. This intervention is essential to detect any early signs of infection, such as redness, swelling, or drainage at the catheter site, which can lead to serious complications like sepsis. Administering intravenous fluids as ordered is important but not the most crucial intervention for a newly inserted central venous catheter. Restricting the child's movement is unnecessary unless specified by the healthcare provider. Performing daily dressing changes alone is not sufficient to ensure the catheter's integrity and the child's safety; monitoring for signs of infection is key.

5. What dietary recommendation is essential for a child with phenylketonuria (PKU)?

• A. High-protein diet
• B. Low-fat diet
• C. Low-phenylalanine diet
• D. High-fiber diet

Correct answer: C

Rationale: The correct answer is C: 'Low-phenylalanine diet.' Children with phenylketonuria (PKU) need to follow a low-phenylalanine diet to manage the condition. Phenylalanine is an amino acid found in protein-containing foods, and individuals with PKU have difficulty metabolizing it, leading to neurological damage and other complications. Therefore, restricting phenylalanine intake is crucial. Choice A, 'High-protein diet,' is incorrect because high protein intake would increase phenylalanine levels, worsening the condition. Choice B, 'Low-fat diet,' and Choice D, 'High-fiber diet,' are not the primary focus for PKU patients. The key dietary intervention for PKU is controlling phenylalanine intake, which is best achieved through a low-phenylalanine diet.

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