Nursing Elites

1. What is the most important intervention for a nurse to implement for a child with sickle cell anemia admitted to the hospital during a vaso-occlusive crisis?

• A. Administering oxygen
• B. Ensuring adequate hydration
• C. Monitoring vital signs
• D. Administering pain medication

Correct answer: B

Rationale: Ensuring adequate hydration is crucial during a vaso-occlusive crisis in sickle cell anemia as it helps to reduce the viscosity of the blood and prevent further sickling of the cells. While administering oxygen may be necessary in some cases, ensuring hydration takes precedence as it directly impacts the underlying pathophysiology of the crisis. Monitoring vital signs is important for ongoing assessment but does not directly address the crisis as hydration does. Administering pain medication is important for pain relief but does not address the primary issue of vaso-occlusion and is not the most crucial intervention in this scenario.

2. A group of students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The primary function of the endocrine system is hormonal secretion. This system is responsible for producing and releasing hormones that regulate various bodily functions such as growth, metabolism, and mood. Choice A, regulation of water balance, is more related to the functions of the renal system rather than the endocrine system. Choice C, cellular metabolism, is a general cellular process that involves various systems, not specific to the endocrine system. Choice D, growth stimulation, though hormones can influence growth, it is not the primary function of the endocrine system. Therefore, the correct answer is B.

3. A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?

• A. Preventing coronary artery aneurysms
• B. Reducing fever
• C. Improving cardiac function
• D. Preventing dehydration

Correct answer: A

Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms, which are a serious complication of this condition. Coronary artery aneurysms can lead to long-term cardiovascular issues, making prevention crucial. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is on preventing coronary artery aneurysms. Dehydration prevention is also essential but not the primary goal during the acute phase of this disease.

4. The nurse is obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism. What would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism in infants often leads to lethargy and difficulty staying awake due to low thyroid hormone levels. Assessing the child's ability to stay awake is crucial in identifying signs of hypothyroidism. Choices A, B, and C are incorrect because above-normal growth, being active and playful, and having healthy-looking skin are not typical manifestations of congenital hypothyroidism. Instead, infants with hypothyroidism may exhibit poor weight gain, decreased activity, and dry, pale skin.

5. A child with a fever is prescribed acetaminophen. What should the nurse teach the parents about administering this medication?

• A. Administer the medication with food
• B. Measure the dose with a household spoon
• C. Measure the dose with a proper measuring device
• D. Administer the medication only when the child has a high fever

Correct answer: C

Rationale: The correct answer is to measure the dose with a proper measuring device. Using a proper measuring device ensures accurate dosing, which is crucial to avoid under or overdosing. Administering the medication with food (Choice A) is not necessary for acetaminophen. Using a household spoon (Choice B) can lead to inaccurate dosing due to variations in spoon sizes. Administering the medication only when the child has a high fever (Choice D) is not appropriate as acetaminophen can be used for fever management regardless of the fever intensity.

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