what should be monitored in a child with congenital adrenal hyperplasia cah
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HESI PN Nutrition Practice Exam

1. What should be monitored in a child with congenital adrenal hyperplasia (CAH)?

Correct answer: B

Rationale: In a child with congenital adrenal hyperplasia (CAH), monitoring electrolyte balance is crucial. CAH can lead to adrenal insufficiency, causing imbalances in electrolytes such as sodium and potassium. Monitoring electrolyte levels helps in preventing complications like dehydration, electrolyte disturbances, and adrenal crisis. While blood glucose levels may need monitoring in other conditions like diabetes, it is not the primary concern in CAH. Urine output is important in assessing kidney function but is not a direct monitoring parameter for CAH. Hemoglobin levels are more relevant in conditions such as anemia, not specifically in CAH.

2. What is a key aspect of managing a child with eczema?

Correct answer: B

Rationale: Regular use of emollients and moisturizers is a key aspect of managing eczema in children. Emollients help maintain skin hydration and reduce irritation, which are crucial in managing eczema symptoms. Daily baths with soap can actually worsen eczema by drying out the skin further. A high-protein diet and frequent exposure to sunlight are not directly related to managing eczema and may not have a significant impact on the condition.

3. What is the priority assessment for a child with suspected appendicitis?

Correct answer: D

Rationale: The priority assessment for a child with suspected appendicitis is 'Pain level.' Evaluating the pain level, particularly in the lower right quadrant, is crucial as it helps in determining the severity of the condition, leading to prompt diagnosis and treatment. Monitoring temperature, heart rate, and respiratory rate are important aspects of assessment; however, they are secondary to assessing the pain level in cases of suspected appendicitis. Pain assessment is key in diagnosing this condition since the classic presentation includes abdominal pain that often starts around the umbilicus and then localizes to the right lower quadrant.

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

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.

5. What type of vaccine should a child with a history of severe allergic reactions receive?

Correct answer: B

Rationale: Children with a history of severe allergic reactions should receive inactivated vaccines because they do not contain live pathogens. Live attenuated vaccines (choice A) contain weakened live pathogens and can potentially trigger an allergic reaction in sensitive individuals. Subunit vaccines (choice C) and recombinant vaccines (choice D) may contain components that could still trigger an allergic response in individuals with a history of severe allergies. Inactivated vaccines are the safest choice for individuals with a history of severe allergic reactions as they do not pose a risk of causing an allergic reaction due to the absence of live pathogens.

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