Nursing Elites

1. What is the most effective therapy for maintaining remission of acute lymphoblastic leukemia?

• A. Surgery to remove enlarged lymph nodes
• B. Long-term chemotherapy
• C. Nutritional supplements to enhance blood cell production
• D. Blood transfusions to replace ineffective red cells

Correct answer: B

Rationale: The correct answer is B: Long-term chemotherapy. Long-term chemotherapy, specifically with methotrexate, is the most effective therapy for maintaining remission in acute lymphoblastic leukemia. Surgery to remove enlarged lymph nodes (Choice A) is not the primary treatment for leukemia. Nutritional supplements (Choice C) may support overall health but are not the mainstay therapy for maintaining leukemia remission. Blood transfusions (Choice D) are used to address anemia in some cases but are not the primary treatment for maintaining remission in acute lymphoblastic leukemia.

2. What will the treatment for a newly admitted child with cystic fibrosis center on?

• A. Chest physiotherapy
• B. Mucus-drying agents
• C. Prevention of diarrhea
• D. Insulin therapy

Correct answer: A

Rationale: The correct answer is A: Chest physiotherapy. Treatment for cystic fibrosis focuses on chest physiotherapy and aerosol medications to manage and clear thick pulmonary secretions. Chest physiotherapy helps loosen and clear mucus from the lungs, aiding in breathing and reducing the risk of infections. Mucus-drying agents (choice B) are not typically used in the treatment of cystic fibrosis as the goal is to help clear mucus, not dry it. Prevention of diarrhea (choice C) is not a primary focus in the treatment of cystic fibrosis. Insulin therapy (choice D) is not relevant to cystic fibrosis, which primarily affects the respiratory and digestive systems.

3. Why must a child with acute laryngotracheobronchitis be kept NPO?

• A. The epinephrine administration may cause nausea and vomiting
• B. The child is being hydrated with IV fluids
• C. The child may not feel hungry
• D. Rapid respirations pose a risk for aspiration

Correct answer: D

Rationale: In acute laryngotracheobronchitis, rapid respirations increase the risk of aspiration due to compromised airway protection and potential for secretions to enter the lungs. Keeping the child NPO helps prevent the risk of aspiration pneumonia. Choice A is incorrect because epinephrine is not typically used for laryngotracheobronchitis. Choice B is incorrect as hydration with IV fluids does not eliminate the risk of aspiration. Choice C is also incorrect because the child being hungry is not the primary reason for keeping them NPO in this condition.

4. Which nutrient source yields more than 4 kcalories per gram?

• A. plant fats
• B. plant proteins
• C. animal proteins
• D. plant carbohydrates

Correct answer: A

Rationale: The correct answer is plant fats (Choice A). Fats, including plant fats, provide 9 kcalories per gram, which is more than 4 kcalories. Plant proteins (Choice B) and animal proteins (Choice C) provide 4 kcalories per gram. Plant carbohydrates (Choice D) also provide 4 kcalories per gram. Therefore, Choices B, C, and D are incorrect because they do not yield more than 4 kcalories per gram.

5. 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.

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