Nursing Elites

1. The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse give regarding alopecia?

• A. Hair usually regrows in two years.
• B. When hair regrows, it may have a slightly different color or texture.
• C. Expose your head to sunlight to minimize alopecia.
• D. Wearing hats and scarves are preferred to wearing a wig.

Correct answer: B

Rationale: The correct answer is B. Hair loss from chemotherapy is usually temporary, and when it regrows, it may have a different color or texture. Sun exposure should be minimized, as the scalp may be more sensitive. Wearing hats and scarves can provide comfort and protection, but there is no preference over wearing a wig. Choice A is incorrect because hair regrowth after chemotherapy varies from person to person and usually occurs sooner than two years. Choice C is incorrect as sun exposure should be minimized to protect the sensitive scalp. Choice D is incorrect as the preference between wearing hats, scarves, or a wig is subjective and depends on the individual's comfort and preferences.

2. What diet is most appropriate for the child with chronic renal failure (CRF)?

• A. Low in protein
• B. Low in vitamin D
• C. Low in phosphorus
• D. Supplemented with vitamins A, E, and K

Correct answer: C

Rationale: A low-phosphorus diet is important in managing chronic renal failure to prevent hyperphosphatemia and its associated complications, such as bone disease. Protein intake should be controlled but not necessarily low, and vitamin D supplementation is often required, not reduced.

3. A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

• A. Propranolol (Inderal)
• B. Calcium gluconate
• C. Mannitol (Osmitrol) or furosemide (Lasix)
• D. Sodium, chloride, and potassium

Correct answer: C

Rationale: Mannitol and furosemide are diuretics commonly used to induce diuresis in acute renal failure, helping to provoke urine flow and manage fluid overload. Calcium gluconate and electrolyte supplementation are used for other specific conditions and not primarily for diuresis.

4. Which laboratory test would be most important for the nurse to assess when caring for a toddler suspected of having cystic fibrosis?

• A. Liver enzymes
• B. Serum calcium
• C. Sweat chloride test
• D. Urine creatinine

Correct answer: C

Rationale: The sweat chloride test is the primary diagnostic test for cystic fibrosis. Cystic fibrosis is characterized by abnormal transport of chloride and sodium across epithelial cell membranes, leading to increased chloride in sweat. This test is crucial for diagnosing cystic fibrosis in suspected cases. Liver enzymes (Choice A), serum calcium (Choice B), and urine creatinine (Choice D) are not specific tests for cystic fibrosis and would not provide the necessary information for diagnosis in this case.

5. The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?

• A. Physiologic manifestations of renal disease
• B. The fact that adolescents have few coping mechanisms
• C. Neurologic manifestations that occur with dialysis
• D. Resentment of the control and enforced dependence imposed by dialysis

Correct answer: D

Rationale: Adolescents may feel anger and depression due to the loss of independence and control over their lives, which is imposed by the need for regular dialysis treatments. This reaction is common as they struggle with the restrictions placed on their social and personal lives.

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