Nursing Elites

1. What is an important consideration when administering medications to a child with hepatic dysfunction?

• A. Increased dosing intervals
• B. Adjustments in dosage due to altered metabolism
• C. Avoid all medications
• D. Use only topical medications

Correct answer: B

Rationale: When administering medications to a child with hepatic dysfunction, it is crucial to make adjustments in dosage due to altered metabolism. Hepatic dysfunction can affect the way medications are metabolized in the body, potentially leading to drug toxicity or reduced effectiveness. This is why adjusting the dosage is essential to ensure the medication is both safe and efficient. Choices A, C, and D are incorrect because increasing dosing intervals, avoiding all medications, or using only topical medications do not address the specific issue of altered drug metabolism in hepatic dysfunction.

2. 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.

3. Which nutrient source yields more than 4 kcalories per gram?

• A. plant fats
• B. plant proteins
• C. animal proteins
• D. plant carbohydrates

Correct answer: A

Rationale: The correct answer is plant fats (Choice A). Fats, including plant fats, provide 9 kcalories per gram, which is more than 4 kcalories. Plant proteins (Choice B) and animal proteins (Choice C) provide 4 kcalories per gram. Plant carbohydrates (Choice D) also provide 4 kcalories per gram. Therefore, Choices B, C, and D are incorrect because they do not yield more than 4 kcalories per gram.

4. Food energy is commonly expressed in kilocalories and in what other unit?

• A. kilojoules
• B. kilograms
• C. kilometers
• D. kilonewtons

Correct answer: A

Rationale: Food energy is commonly expressed in kilocalories and kilojoules. Kilocalories and kilojoules are both units of energy commonly used to measure the energy content of food. Kilograms, kilometers, and kilonewtons are units of mass, distance, and force, respectively, and are not used to express food energy.

5. 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.

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