Nursing Elites

1. What action should be taken for a 2-year-old with laryngotracheobronchitis in an oxygen tent?

• A. Restrain the child and notify the healthcare provider
• B. Increase the oxygen concentration
• C. Take the child to the playroom
• D. Ask the mother to help in comforting the child

Correct answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

2. What is an important aspect of managing a child with chronic kidney disease?

• A. Monitoring electrolyte levels
• B. Increasing protein intake
• C. Limiting fluid intake
• D. Encouraging a high-fat diet

Correct answer: A

Rationale: Monitoring electrolyte levels is crucial in managing chronic kidney disease in children because imbalances can lead to serious complications. Electrolyte levels must be carefully monitored to prevent issues such as electrolyte abnormalities, which can further impact kidney function and overall health. Choices B, C, and D are incorrect because increasing protein intake, limiting fluid intake, and encouraging a high-fat diet can exacerbate kidney disease in children by putting extra strain on their kidneys or causing other health problems.

3. What is a key aspect of care for a child with an indwelling urinary catheter?

• A. Increase fluid intake
• B. Monitor for signs of infection
• C. Restrict mobility
• D. Administer daily antibiotics

Correct answer: B

Rationale: Monitoring for signs of infection is crucial when caring for a child with an indwelling urinary catheter. This is because catheter-associated urinary tract infections are common in such cases. Increasing fluid intake can be beneficial, but monitoring for infection takes precedence as it is crucial to prevent complications. Restricting mobility is not a key aspect of care for a child with an indwelling urinary catheter unless specifically advised by a healthcare provider. Administering daily antibiotics without proper assessment and indication can lead to antibiotic resistance and is not a standard practice in caring for a child with an indwelling urinary catheter.

4. 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.

5. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

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