Nursing Elites

1. What is the most important intervention in the management of a child with sickle cell crisis?

• A. Administration of iron supplements
• B. Initiation of high-calorie diet
• C. Administration of pain relief
• D. Limiting fluid intake

Correct answer: C

Rationale: The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications. Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis. Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis. Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.

2. A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention?

• A. Reassure the mother that this is normal at this age
• B. Recommend the mother substitute a pacifier for her thumb
• C. Assess the infant for other signs of sensory deprivation
• D. Suggest the mother breastfeed the infant more often to satisfy her sucking needs

Correct answer: A

Rationale: Thumb sucking is a normal self-soothing behavior in infants and usually does not indicate a problem. Reassuring the mother that this is normal is the appropriate response.

3. Which characteristic best describes the fine motor skills of an infant at age 5 months?

• A. Neat pincer grasp
• B. Strong grasp reflex
• C. Builds a tower of two cubes
• D. Able to grasp object voluntarily

Correct answer: D

Rationale: By 5 months, infants develop the ability to grasp objects voluntarily, showing improved motor control. The neat pincer grasp and building towers are skills that develop later.

4. A sixteen-year-old boy is diagnosed with osteosarcoma. What information should the nurse know regarding the treatment plan?

• A. Amputation of the affected extremity is rarely necessary.
• B. Intensive radiation is the primary treatment modality.
• C. Treatment usually consists of surgery and chemotherapy.
• D. Bone marrow transplantation is the preferred option for long-term survival.

Correct answer: C

Rationale: Osteosarcoma is typically treated with a combination of surgery and chemotherapy. This approach aims to remove the tumor and reduce the risk of metastasis. Amputation of the affected extremity may be necessary in some cases to ensure complete removal of the tumor. Intensive radiation is not the primary treatment for osteosarcoma, and bone marrow transplantation is not the standard treatment for this type of cancer.

5. Melena, the passage of black, tarry stools, suggests bleeding from which source?

• A. The perianal or rectal area
• B. The upper gastrointestinal (GI) tract
• C. The lower GI tract
• D. Hemorrhoids or anal fissures

Correct answer: B

Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.

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