Nursing Elites

1. Which individual is making a food choice based on negative association?

• A. A tourist from China who rejects a hamburger due to unfamiliarity
• B. A child who spits out his mashed potatoes because they taste too salty
• C. A teenager who grudgingly accepts an offer for an ice cream cone to avoid offending a close friend
• D. An elderly gentleman who refuses a peanut butter and jelly sandwich because he considers it a child's food

Correct answer: D

Rationale: Choice D is the correct answer because the elderly gentleman is refusing the peanut butter and jelly sandwich due to his negative association of considering it a child's food. This negative association influences his food choice. Choices A, B, and C do not involve negative associations with the food being consumed. Choice A is based on unfamiliarity, Choice B is due to taste preference, and Choice C is driven by social considerations rather than negative food association.

2. How should a healthcare professional manage a child with a newly inserted central venous catheter?

• A. Monitor for signs of infection
• B. Restrict all physical activity
• C. Administer routine antibiotics
• D. Increase fluid intake only

Correct answer: A

Rationale: Monitoring for signs of infection is crucial in managing a central venous catheter to prevent complications. This involves observing for redness, swelling, warmth, or drainage at the catheter site, as these can indicate an infection. Restricting physical activity unnecessarily (choice B) can hinder the child's recovery and quality of life. Administering routine antibiotics (choice C) without a confirmed infection can lead to antibiotic resistance and unnecessary side effects. Increasing fluid intake only (choice D) is not the primary intervention for managing a central venous catheter.

3. What should be included in the medical management of a sickle cell crisis?

• A. Information for parents on home care
• B. Adequate hydration and pain management
• C. Pain management and iron supplements
• D. Adequate oxygenation and factor VIII

Correct answer: B

Rationale: The correct answer is B: Adequate hydration and pain management. During a sickle cell crisis, it is essential to provide hydration to prevent vaso-occlusive events and manage pain effectively with analgesics. Adequate hydration helps maintain blood flow and prevent further sickling of red blood cells. Pain management is crucial to alleviate the severe pain associated with sickle cell crises. Options A, C, and D are incorrect. Providing information for parents on home care (Option A) may be important for ongoing management but is not specific to an acute crisis. Iron supplements (Option C) are not typically indicated during a sickle cell crisis. Adequate oxygenation and factor VIII (Option D) are not primary interventions for managing a sickle cell crisis; instead, oxygen therapy may be considered in severe cases, and factor VIII is not a standard treatment for sickle cell disease.

4. 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.

5. How should hydration status be assessed in a child with vomiting and diarrhea?

• A. Check skin turgor and mucous membranes
• B. Measure blood glucose levels
• C. Assess heart rate and blood pressure
• D. Evaluate bowel sounds

Correct answer: A

Rationale: Checking skin turgor and mucous membranes is the appropriate method to assess hydration status in a child with vomiting and diarrhea. Skin turgor is an indicator of skin elasticity, which decreases when an individual is dehydrated. Mucous membranes, such as the inside of the mouth, can also show signs of dehydration like dryness. Measuring blood glucose levels (choice B) is not relevant to assessing hydration status in this scenario. Assessing heart rate and blood pressure (choice C) is important in evaluating the overall condition of a child but may not directly indicate hydration status. Evaluating bowel sounds (choice D) is more related to assessing gastrointestinal function rather than hydration status.

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