Nursing Elites

1. What is critical for preventing complications in an infant with hypothyroidism?

• A. Excessive growth
• B. Cognitive impairment
• C. Damage to the nervous system
• D. Damage to the urinary system

Correct answer: B

Rationale: The correct answer is B: Cognitive impairment. In infants with hypothyroidism, prompt administration of oral thyroid hormone replacement is crucial to prevent cognitive impairment and other serious complications. Excessive growth (choice A) is not a typical complication of hypothyroidism in infants. While hypothyroidism can affect the nervous system (choice C), cognitive impairment is more specific to untreated cases. Damage to the urinary system (choice D) is not a common complication of hypothyroidism in infants.

2. 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.

3. What is the most common initial symptom of juvenile idiopathic arthritis?

• A. Joint swelling and pain
• B. Skin rash
• C. Gastrointestinal bleeding
• D. Neurological deficits

Correct answer: A

Rationale: The correct answer is A: Joint swelling and pain. These are the most common initial symptoms of juvenile idiopathic arthritis, typically affecting multiple joints. Skin rash (choice B), gastrointestinal bleeding (choice C), and neurological deficits (choice D) are not typical initial symptoms of juvenile idiopathic arthritis. Skin rash may be seen in other conditions like dermatitis or systemic lupus erythematosus, gastrointestinal bleeding may be associated with conditions like inflammatory bowel disease, and neurological deficits could be indicative of conditions like multiple sclerosis.

4. 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.

5. The parents of a child with sickle cell anemia ask why their child experiences pain. What is the most likely cause?

• A. Inflammation of the vessels
• B. Obstructed blood flow
• C. Overhydration
• D. Stress-related headaches

Correct answer: B

Rationale: In sickle cell anemia, pain is primarily caused by the obstruction of blood flow by sickle-shaped cells. This obstruction leads to inadequate oxygen supply to tissues, resulting in tissue damage and pain. Choice A, inflammation of the vessels, is incorrect as it is not the primary cause of pain in sickle cell anemia. Choice C, overhydration, is unrelated to the pathophysiology of sickle cell anemia and would not lead to the characteristic pain experienced. Choice D, stress-related headaches, is also unrelated to the underlying mechanisms of pain in sickle cell anemia.

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