Nursing Elites

1. Which dietary information should the nurse include in the teaching plan for a school-age child with chronic renal failure?

• A. High in sodium
• B. Low in Vitamin D
• C. Low in phosphorus
• D. Supplementation of vitamins C, E, K

Correct answer: C

Rationale: A low-phosphorus diet is recommended for children with chronic renal failure to prevent hyperphosphatemia, which can lead to bone disease and other complications. Phosphorus is found in many processed foods and should be limited. Choices A, B, and D are incorrect because high sodium intake can lead to fluid retention and hypertension, while Vitamin D supplementation and vitamins C, E, K are not specifically indicated for dietary recommendations in chronic renal failure.

2. Pretending a sheet is a cape to mimic a superhero is characteristic of which childhood phenomenon?

• A. Artificialism
• B. Symbolic functioning
• C. Critical thinking
• D. Dramatic play

Correct answer: B

Rationale: The correct answer is B, symbolic functioning. Symbolic functioning refers to children using objects, actions, or ideas to represent other objects, actions, or ideas. In this scenario, pretending a sheet is a cape to mimic a superhero demonstrates the child's ability to engage in symbolic play. Choice A, artificialism, is incorrect as it refers to the belief that inanimate objects have lifelike qualities. Choice C, critical thinking, does not directly relate to the imaginative play described in the question. Choice D, dramatic play, is close but not as precise as symbolic functioning, which specifically highlights the use of objects to represent something else.

3. Physiologically, the child compensates for fluid volume losses by which mechanism?

• A. Inhibition of aldosterone secretion
• B. Hemoconcentration to reduce cardiac workload
• C. Fluid shift from interstitial space to intravascular space
• D. Vasodilation of peripheral arterioles to increase perfusion

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

4. What is a clinical manifestation of acetaminophen poisoning?

• A. Hyperpyrexia
• B. Hepatic involvement
• C. Severe burning pain in stomach
• D. Drooling and inability to clear secretions

Correct answer: B

Rationale: Acetaminophen poisoning primarily affects the liver, leading to hepatic involvement, which may present as jaundice, liver failure, or elevated liver enzymes. Hyperpyrexia, severe pain, and drooling are more associated with other types of poisoning.

5. What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

• A. White rice
• B. Popcorn
• C. Fruit juice
• D. Ripe bananas

Correct answer: B

Rationale: Popcorn is a high-fiber food that can help manage chronic constipation in children. Other options like white rice and ripe bananas are low in fiber and less effective for treating constipation.

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