Nursing Elites

1. What is an important consideration when administering medications to a child with a history of chronic renal failure?

• A. Increased frequency of medication administration
• B. Adjustments in dosage due to altered drug metabolism
• C. Avoidance of all medications
• D. Use of only intravenous medications

Correct answer: B

Rationale: When administering medications to a child with chronic renal failure, it is crucial to consider adjustments in dosage due to altered drug metabolism. Children with chronic renal failure may have impaired drug excretion, leading to potential drug accumulation and toxicity. Increasing the frequency of medication administration (choice A) may not address the altered drug metabolism issue and could increase the risk of adverse effects. Avoiding all medications (choice C) is not practical or safe as some medications may be necessary for the child's health. Using only intravenous medications (choice D) is not always required and may not be the best route of administration for all medications needed.

2. Gram for gram, which class of nutrient provides the most energy?

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

Correct answer: A

Rationale: The correct answer is fats. Fats provide 9 kilocalories per gram, which is more energy-dense compared to proteins and carbohydrates. While proteins and carbohydrates provide 4 kilocalories per gram, fats provide more than twice the energy, making them the most energy-providing nutrient. Alcohols are not considered essential nutrients and do not provide energy for the body, unlike fats, proteins, and carbohydrates. Therefore, fats are the correct answer for the most energy-providing nutrient.

3. What is a primary concern for a child with a new diagnosis of diabetes mellitus?

• A. Increased growth rate
• B. Risk of hyperglycemia
• C. Risk of dehydration
• D. Improved appetite

Correct answer: B

Rationale: The correct answer is B: Risk of hyperglycemia. When a child is newly diagnosed with diabetes mellitus, one of the primary concerns is the risk of hyperglycemia, which refers to high blood glucose levels. Hyperglycemia can lead to various complications if not managed properly, making it crucial to stabilize blood glucose levels. Choices A, C, and D are incorrect because increased growth rate, risk of dehydration, and improved appetite are not primary concerns specifically associated with a new diagnosis of diabetes mellitus.

4. What is a common symptom of a vitamin D deficiency in children?

• A. Frequent infections
• B. Bone pain and tenderness
• C. Excessive thirst
• D. Unexplained bruising

Correct answer: B

Rationale: Bone pain and tenderness are indeed common symptoms of vitamin D deficiency in children. Vitamin D plays a crucial role in bone health and growth. The deficiency can lead to weakened bones, causing pain and tenderness. Choices A, C, and D are incorrect. Frequent infections are not a typical symptom of vitamin D deficiency in children; excessive thirst is more commonly associated with conditions like diabetes, and unexplained bruising is not directly linked to vitamin D deficiency.

5. 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.

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