Nursing Elites

1. How should pain be assessed in a nonverbal child?

• A. Ask the parents about the child’s usual behavior
• B. Observe the child’s facial expressions and body movements
• C. Measure the child’s blood pressure
• D. Use a pain rating scale for older children

Correct answer: B

Rationale: Observing the nonverbal child's facial expressions and body movements is crucial in assessing pain. Nonverbal children may not be able to communicate their discomfort verbally, making it essential to rely on physical cues. Asking parents about the child's usual behavior (choice A) may provide some insight but observing the child directly is more direct and reliable. Measuring blood pressure (choice C) is not typically a direct method for assessing pain in nonverbal children. Using a pain rating scale designed for older children (choice D) is also inappropriate for nonverbal children who cannot participate in such self-reporting tools.

2. What is an important dietary consideration for a child with celiac disease?

• A. Increased iron intake
• B. Gluten-free diet
• C. High-protein diet
• D. Low-sodium diet

Correct answer: B

Rationale: A gluten-free diet is crucial for managing celiac disease in children because it helps prevent intestinal damage and alleviate symptoms. Gluten is a protein found in wheat, barley, and rye, and it triggers an immune response in individuals with celiac disease, damaging the lining of the small intestine. Therefore, choices A, C, and D are incorrect. While iron intake is important for overall health, a child with celiac disease can still meet their iron needs through sources that are naturally gluten-free or fortified. A high-protein diet or a low-sodium diet are not specifically required for managing celiac disease.

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

• A. Temperature
• B. Heart rate
• C. Respiratory rate
• D. Pain level

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. How should a caregiver manage a child with a new diagnosis of sickle cell anemia?

• A. Ensure the child receives frequent blood transfusions
• B. Promote adequate hydration and pain management
• C. Restrict physical activity
• D. Administer high doses of vitamin C

Correct answer: B

Rationale: Promoting adequate hydration and pain management is crucial for managing sickle cell anemia to prevent crises and complications. Adequate hydration helps prevent sickling of red blood cells, while effective pain management is essential for addressing the frequent pain episodes associated with the condition. Ensuring the child receives frequent blood transfusions is not the initial management for sickle cell anemia; transfusions are usually reserved for specific complications. Restricting physical activity should be individualized based on the child's condition; some physical activity is beneficial for overall health. Administering high doses of vitamin C is not a standard treatment for sickle cell anemia and does not address the underlying pathology of the disease.

5. What should be monitored in a child receiving chemotherapy?

• A. Blood glucose levels
• B. Blood cell counts
• C. Weight gain
• D. Skin elasticity

Correct answer: B

Rationale: The correct answer is monitoring blood cell counts. During chemotherapy, it is crucial to monitor blood cell counts to detect potential side effects such as neutropenia (low white blood cell count) and anemia (low red blood cell count). These conditions can increase the risk of infections and fatigue. Monitoring blood glucose levels (Choice A) is not typically a primary concern in children receiving chemotherapy unless they have pre-existing conditions like diabetes. Weight gain (Choice C) and skin elasticity (Choice D) are not directly related to monitoring the effects of chemotherapy in children. Therefore, the most important parameter to monitor in a child receiving chemotherapy is blood cell counts.

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