Nursing Elites

1. How should the nurse manage a child with acute lymphoblastic leukemia (ALL) who is receiving chemotherapy?

• A. Avoid all physical activity
• B. Ensure strict infection control measures
• C. Increase daily caloric intake
• D. Limit fluid intake

Correct answer: B

Rationale: The correct answer is B: Ensure strict infection control measures. Children with acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy have compromised immune systems, making them highly susceptible to infections. Implementing strict infection control measures, such as hand hygiene, limiting exposure to sick individuals, and maintaining a clean environment, is essential to prevent infections. Choice A is incorrect because avoiding all physical activity may not be necessary as long as the child's activity level is appropriate. Choice C is incorrect because increasing daily caloric intake is important to support the child's nutritional needs during treatment. Choice D is incorrect because limiting fluid intake is not typically recommended unless specifically advised by the healthcare provider.

2. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

3. What type of vaccine should a child with a history of severe allergic reactions receive?

• A. Live attenuated vaccines
• B. Inactivated vaccines
• C. Subunit vaccines
• D. Recombinant vaccines

Correct answer: B

Rationale: Children with a history of severe allergic reactions should receive inactivated vaccines because they do not contain live pathogens. Live attenuated vaccines (choice A) contain weakened live pathogens and can potentially trigger an allergic reaction in sensitive individuals. Subunit vaccines (choice C) and recombinant vaccines (choice D) may contain components that could still trigger an allergic response in individuals with a history of severe allergies. Inactivated vaccines are the safest choice for individuals with a history of severe allergic reactions as they do not pose a risk of causing an allergic reaction due to the absence of live pathogens.

4. What should be monitored in a child with congenital adrenal hyperplasia (CAH)?

• A. Blood glucose levels
• B. Electrolyte balance
• C. Urine output
• D. Hemoglobin levels

Correct answer: B

Rationale: In a child with congenital adrenal hyperplasia (CAH), monitoring electrolyte balance is crucial. CAH can lead to adrenal insufficiency, causing imbalances in electrolytes such as sodium and potassium. Monitoring electrolyte levels helps in preventing complications like dehydration, electrolyte disturbances, and adrenal crisis. While blood glucose levels may need monitoring in other conditions like diabetes, it is not the primary concern in CAH. Urine output is important in assessing kidney function but is not a direct monitoring parameter for CAH. Hemoglobin levels are more relevant in conditions such as anemia, not specifically in CAH.

5. Farah is viewing an exciting sports match of her favorite team and eating because of nervousness. Her food choice will most likely be based on ___.

• A. regional cuisines
• B. preferences
• C. emotional comfort
• D. positive association

Correct answer: C

Rationale: During stressful situations like watching an exciting sports match, individuals often seek emotional comfort through food. This emotional connection can lead Farah to choose foods that provide comfort or familiarity rather than being based on regional cuisines (choice A), general preferences (choice B), or positive associations (choice D). Farah's food choice is likely driven by the need for emotional comfort to alleviate her nervousness, making option C the most suitable answer.

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