Nursing Elites

1. How should a healthcare professional manage a child with a newly inserted gastrostomy tube?

• A. Monitor for signs of infection
• B. Increase the child's fluid intake
• C. Restrict all oral intake
• D. Use only sterile equipment for feedings

Correct answer: A

Rationale: Monitoring for signs of infection at the gastrostomy site is crucial for ensuring proper care and preventing complications. This involves observing for redness, swelling, warmth, or drainage around the insertion site. Increasing the child's fluid intake (Choice B) may be beneficial for hydration but is not specifically related to managing a newly inserted gastrostomy tube. Restricting all oral intake (Choice C) is not necessary as long as the healthcare professional follows the recommended guidelines for feeding. While using sterile equipment for feedings (Choice D) is important, monitoring for signs of infection takes precedence in the immediate post-insertion period.

2. What is a key dietary consideration for a child with phenylketonuria (PKU)?

• A. High-fiber diet
• B. Low-phenylalanine diet
• C. Increased dairy intake
• D. High-sodium diet

Correct answer: B

Rationale: A low-phenylalanine diet is crucial for managing PKU to prevent neurological damage and maintain normal development. Phenylalanine is an amino acid found in protein-containing foods, and individuals with PKU have difficulty metabolizing it. Consuming foods low in phenylalanine helps prevent the buildup of toxic byproducts in the body. Choices A, C, and D are incorrect. A high-fiber diet, increased dairy intake, and high-sodium diet are not specific dietary considerations for PKU management. In fact, dairy products are a source of protein and phenylalanine, which should be limited in PKU.

3. How should a healthcare provider respond to a parent concerned about their child's frequent ear infections?

• A. Recommend over-the-counter ear drops
• B. Suggest an ENT specialist evaluation
• C. Advise on increasing fluid intake
• D. Encourage more physical exercise

Correct answer: B

Rationale: When a parent expresses concerns about their child's frequent ear infections, suggesting an ENT specialist evaluation is the most appropriate response. This specialist can conduct a thorough examination to identify the underlying cause of the recurrent infections and recommend the most suitable treatment. Recommending over-the-counter ear drops (Choice A) may not address the root cause of the issue and could potentially lead to inappropriate treatment. Advising on increasing fluid intake (Choice C) and encouraging more physical exercise (Choice D) are unrelated to addressing the specific concern of frequent ear infections.

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. What is the primary treatment for a child with an anaphylactic reaction?

• A. Oral antihistamines
• B. Intravenous fluids
• C. Epinephrine injection
• D. Antipyretics

Correct answer: C

Rationale: The correct answer is C: Epinephrine injection. An epinephrine injection is the primary treatment for an anaphylactic reaction in children. Epinephrine acts quickly to reverse severe symptoms such as difficulty breathing, low blood pressure, and hives. Oral antihistamines, although useful for milder allergic reactions, are not sufficient to manage the potentially life-threatening symptoms of anaphylaxis. Intravenous fluids may be necessary to support blood pressure in a child with anaphylaxis but are not the primary treatment. Antipyretics, on the other hand, are medications used to reduce fever and are not indicated as the primary treatment for an anaphylactic reaction.

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