Nursing Elites

1. What should be assessed first in a child with suspected head trauma?

• A. Response to verbal stimuli
• B. Pupillary reaction
• C. Skin color
• D. Heart rate

Correct answer: A

Rationale: The correct answer is to assess the response to verbal stimuli first in a child with suspected head trauma. This assessment helps in determining the child's level of consciousness and neurological status. Assessing the response to verbal stimuli allows healthcare providers to quickly evaluate if the child is alert, oriented, and able to communicate effectively. This initial assessment is crucial in identifying any immediate concerns related to the child's neurological function. Choices B, C, and D are not the primary assessments in cases of suspected head trauma. While pupillary reaction, skin color, and heart rate are important assessments in trauma situations, assessing the response to verbal stimuli takes precedence in evaluating the neurological status of a child with head trauma.

2. 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.

3. How should a caregiver handle a child with a known peanut allergy?

• A. Educate on allergen avoidance
• B. Increase exposure to peanuts
• C. Administer antihistamines as needed
• D. Suggest occasional consumption of peanuts

Correct answer: A

Rationale: Educating on allergen avoidance is the correct approach when dealing with a child who has a known peanut allergy. This helps in managing the allergy effectively and preventing potential allergic reactions. Increasing exposure to peanuts (Choice B) is dangerous and can trigger severe allergic reactions in a child with a peanut allergy. While antihistamines (Choice C) can help alleviate some symptoms, they should not be the primary method of managing a peanut allergy. Suggesting occasional consumption of peanuts (Choice D) is extremely risky and should never be done for a child with a known peanut allergy.

4. What dietary recommendation is essential for a child with phenylketonuria (PKU)?

• A. High-protein diet
• B. Low-fat diet
• C. Low-phenylalanine diet
• D. High-fiber diet

Correct answer: C

Rationale: The correct answer is C: 'Low-phenylalanine diet.' Children with phenylketonuria (PKU) need to follow a low-phenylalanine diet to manage the condition. Phenylalanine is an amino acid found in protein-containing foods, and individuals with PKU have difficulty metabolizing it, leading to neurological damage and other complications. Therefore, restricting phenylalanine intake is crucial. Choice A, 'High-protein diet,' is incorrect because high protein intake would increase phenylalanine levels, worsening the condition. Choice B, 'Low-fat diet,' and Choice D, 'High-fiber diet,' are not the primary focus for PKU patients. The key dietary intervention for PKU is controlling phenylalanine intake, which is best achieved through a low-phenylalanine diet.

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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