Nursing Elites

1. 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.

2. What is a common symptom of a vitamin D deficiency in children?

• A. Frequent infections
• B. Bone pain and tenderness
• C. Excessive thirst
• D. Unexplained bruising

Correct answer: B

Rationale: Bone pain and tenderness are indeed common symptoms of vitamin D deficiency in children. Vitamin D plays a crucial role in bone health and growth. The deficiency can lead to weakened bones, causing pain and tenderness. Choices A, C, and D are incorrect. Frequent infections are not a typical symptom of vitamin D deficiency in children; excessive thirst is more commonly associated with conditions like diabetes, and unexplained bruising is not directly linked to vitamin D deficiency.

3. What is a key sign of meningitis in an infant?

• A. Increased appetite
• B. Bulging fontanel
• C. Decreased respiratory rate
• D. Elevated blood pressure

Correct answer: B

Rationale: A bulging fontanel is a key sign of meningitis in infants, indicating increased intracranial pressure due to inflammation of the meninges. This can lead to the fontanel bulging. Choices A, C, and D are incorrect. Increased appetite is not typically associated with meningitis in infants; instead, they may have poor feeding. A decreased respiratory rate is not a common sign of meningitis in infants. Elevated blood pressure is also not a typical finding in infants with meningitis.

4. Which measure best describes the amounts of nutrients that should be consumed by the population?

• A. The Dietary Reference Intakes, as they provide a set of nutrient intake values for healthy people in the United States and Canada
• B. The Tolerable Upper Intake levels, as they indicate the maximum daily amount of a nutrient considered safe for most healthy people
• C. The Estimated Average Requirements, as they reflect the average daily amount of a nutrient needed to maintain a specific function in half of the healthy individuals of a population
• D. The Recommended Dietary Allowances, as they represent the average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy individuals

Correct answer: D

Rationale: The Recommended Dietary Allowances (RDAs) are the best measure to describe the amounts of nutrients that should be consumed by the population. RDAs represent the average daily intake level that meets the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group. Choice A, the Dietary Reference Intakes, provide a set of nutrient intake values but do not specifically address the average daily amount of a nutrient considered adequate for practically all individuals. Choice B, the Tolerable Upper Intake levels, focus on the maximum daily amount of a nutrient deemed safe for most healthy people, not the average daily amount needed. Choice C, the Estimated Average Requirements, reflect the average daily amount of a nutrient needed by half of the healthy individuals, which is not as comprehensive as the RDAs that cater to nearly all healthy people.

5. 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.

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