Nursing Elites

1. What is an important consideration when administering medications to a child with a history of chronic renal failure?

• A. Increased frequency of medication administration
• B. Adjustments in dosage due to altered drug metabolism
• C. Avoidance of all medications
• D. Use of only intravenous medications

Correct answer: B

Rationale: When administering medications to a child with chronic renal failure, it is crucial to consider adjustments in dosage due to altered drug metabolism. Children with chronic renal failure may have impaired drug excretion, leading to potential drug accumulation and toxicity. Increasing the frequency of medication administration (choice A) may not address the altered drug metabolism issue and could increase the risk of adverse effects. Avoiding all medications (choice C) is not practical or safe as some medications may be necessary for the child's health. Using only intravenous medications (choice D) is not always required and may not be the best route of administration for all medications needed.

2. What action should be taken for a 2-year-old with laryngotracheobronchitis in an oxygen tent?

• A. Restrain the child and notify the healthcare provider
• B. Increase the oxygen concentration
• C. Take the child to the playroom
• D. Ask the mother to help in comforting the child

Correct answer: B

Rationale: In laryngotracheobronchitis (croup), a child may become restless due to poor oxygenation. Increasing the oxygen concentration in the oxygen tent is crucial to improve oxygenation levels and manage symptoms effectively. Restraint is not appropriate in this situation, as it may cause distress and worsen the child's condition. Taking the child to the playroom is not indicated when the child requires oxygen therapy. While comforting the child is important, the priority in this scenario is to optimize oxygen delivery to improve respiratory distress.

3. What should be included in the medical management of a sickle cell crisis?

• A. Information for parents on home care
• B. Adequate hydration and pain management
• C. Pain management and iron supplements
• D. Adequate oxygenation and factor VIII

Correct answer: B

Rationale: The correct answer is B: Adequate hydration and pain management. During a sickle cell crisis, it is essential to provide hydration to prevent vaso-occlusive events and manage pain effectively with analgesics. Adequate hydration helps maintain blood flow and prevent further sickling of red blood cells. Pain management is crucial to alleviate the severe pain associated with sickle cell crises. Options A, C, and D are incorrect. Providing information for parents on home care (Option A) may be important for ongoing management but is not specific to an acute crisis. Iron supplements (Option C) are not typically indicated during a sickle cell crisis. Adequate oxygenation and factor VIII (Option D) are not primary interventions for managing a sickle cell crisis; instead, oxygen therapy may be considered in severe cases, and factor VIII is not a standard treatment for sickle cell disease.

4. How should the healthcare provider respond to a parent concerned about a child's short stature?

• A. Suggest the parent consult a nutritionist
• B. Recommend frequent growth hormone injections
• C. Advise monitoring for a few years before intervention
• D. Refer for a genetic evaluation

Correct answer: C

Rationale: When a parent expresses concern about a child's short stature, the initial approach should involve advising monitoring for a few years before considering any interventions. This allows for observation of the child's growth pattern and any potential underlying issues. Suggesting a nutritionist (Choice A) may not be necessary if there are no signs of nutritional deficiencies. Recommending growth hormone injections (Choice B) is premature without proper evaluation and diagnosis. Referring for a genetic evaluation (Choice D) can be considered later if monitoring shows atypical growth patterns or other concerning factors.

5. 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.

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