Nursing Elites

1. 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.

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. Before publication in a reputable journal, the findings of a research study must undergo scrutiny by experts in the field in a process known as what?

• A. peer review
• B. cohort review
• C. research intervention
• D. double-blind examination

Correct answer: A

Rationale: The correct answer is A: peer review. Before publication, research findings must undergo peer review, where experts in the field evaluate the validity and significance of the study. Choice B, cohort review, is incorrect as it does not involve the same level of evaluation by experts. Choice C, research intervention, is not a term used to describe the evaluation process before publication. Choice D, double-blind examination, refers to a study design where neither the participants nor the researchers know who is receiving a particular treatment, which is not the same as the peer review process.

4. What should the nurse anticipate as challenging in caring for a child with acute glomerulonephritis?

• A. Forced fluids
• B. Increased feedings
• C. Bed rest
• D. Frequent position changes

Correct answer: C

Rationale: The correct answer is C: Bed rest. Implementing bed rest can be challenging, especially in active children, but it's necessary to manage the symptoms of acute glomerulonephritis. Forced fluids (choice A) may be required to maintain hydration but are not typically challenging. Increased feedings (choice B) and frequent position changes (choice D) are not primary interventions in the care of a child with acute glomerulonephritis.

5. What is the most effective therapy for maintaining remission of acute lymphoblastic leukemia?

• A. Surgery to remove enlarged lymph nodes
• B. Long-term chemotherapy
• C. Nutritional supplements to enhance blood cell production
• D. Blood transfusions to replace ineffective red cells

Correct answer: B

Rationale: The correct answer is B: Long-term chemotherapy. Long-term chemotherapy, specifically with methotrexate, is the most effective therapy for maintaining remission in acute lymphoblastic leukemia. Surgery to remove enlarged lymph nodes (Choice A) is not the primary treatment for leukemia. Nutritional supplements (Choice C) may support overall health but are not the mainstay therapy for maintaining leukemia remission. Blood transfusions (Choice D) are used to address anemia in some cases but are not the primary treatment for maintaining remission in acute lymphoblastic leukemia.

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