Nursing Elites

1. How should a healthcare professional manage a child with a newly inserted central venous catheter?

• A. Monitor for signs of infection
• B. Restrict all physical activity
• C. Administer routine antibiotics
• D. Increase fluid intake only

Correct answer: A

Rationale: Monitoring for signs of infection is crucial in managing a central venous catheter to prevent complications. This involves observing for redness, swelling, warmth, or drainage at the catheter site, as these can indicate an infection. Restricting physical activity unnecessarily (choice B) can hinder the child's recovery and quality of life. Administering routine antibiotics (choice C) without a confirmed infection can lead to antibiotic resistance and unnecessary side effects. Increasing fluid intake only (choice D) is not the primary intervention for managing a central venous catheter.

2. The parents of a child with sickle cell anemia ask why their child experiences pain. What is the most likely cause?

• A. Inflammation of the vessels
• B. Obstructed blood flow
• C. Overhydration
• D. Stress-related headaches

Correct answer: B

Rationale: In sickle cell anemia, pain is primarily caused by the obstruction of blood flow by sickle-shaped cells. This obstruction leads to inadequate oxygen supply to tissues, resulting in tissue damage and pain. Choice A, inflammation of the vessels, is incorrect as it is not the primary cause of pain in sickle cell anemia. Choice C, overhydration, is unrelated to the pathophysiology of sickle cell anemia and would not lead to the characteristic pain experienced. Choice D, stress-related headaches, is also unrelated to the underlying mechanisms of pain in sickle cell anemia.

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. Which measure best describes the amounts of nutrients that should be consumed by the population?

• A. The Dietary Reference Intakes, as they provide a set of nutrient intake values for healthy people in the United States and Canada
• B. The Tolerable Upper Intake levels, as they indicate the maximum daily amount of a nutrient considered safe for most healthy people
• C. The Estimated Average Requirements, as they reflect the average daily amount of a nutrient needed to maintain a specific function in half of the healthy individuals of a population
• D. The Recommended Dietary Allowances, as they represent the average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy individuals

Correct answer: D

Rationale: The Recommended Dietary Allowances (RDAs) are the best measure to describe the amounts of nutrients that should be consumed by the population. RDAs represent the average daily intake level that meets the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group. Choice A, the Dietary Reference Intakes, provide a set of nutrient intake values but do not specifically address the average daily amount of a nutrient considered adequate for practically all individuals. Choice B, the Tolerable Upper Intake levels, focus on the maximum daily amount of a nutrient deemed safe for most healthy people, not the average daily amount needed. Choice C, the Estimated Average Requirements, reflect the average daily amount of a nutrient needed by half of the healthy individuals, which is not as comprehensive as the RDAs that cater to nearly all healthy people.

5. Which lab result should be abnormal in a child with hemophilia?

• A. Prothrombin time
• B. Bleeding time
• C. Platelet count
• D. Partial thromboplastin time

Correct answer: D

Rationale: In a child with hemophilia, the lab result that should be abnormal is the partial thromboplastin time (PTT). Hemophilia is a disorder that affects the clotting factors in the intrinsic pathway of coagulation, leading to a prolonged PTT. Prothrombin time (Choice A) assesses the extrinsic pathway and should be normal in hemophilia. Bleeding time (Choice B) evaluates platelet function, which is typically normal in hemophilia. Platelet count (Choice C) measures the number of platelets and is not directly affected by hemophilia.

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