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. In what position should infants be placed to sleep to reduce the risk of sudden infant death syndrome (SIDS)?

• A. Right side-lying
• B. Left side-lying
• C. Prone
• D. Supine

Correct answer: D

Rationale: The American Academy of Pediatrics recommends placing infants on their backs (supine) to sleep to reduce the risk of sudden infant death syndrome (SIDS). This position has been shown to decrease the likelihood of SIDS occurrence. Placing infants on their right or left side (choices A and B) or prone (choice C) can increase the risk of SIDS as it may obstruct the infant's airway or lead to overheating, which are known risk factors for SIDS.

3. What is the recommended treatment for a child with a first-degree burn?

• A. Immediate application of ice
• B. Administration of oral antibiotics
• C. Application of cool, moist compresses
• D. Application of hot packs

Correct answer: C

Rationale: The recommended treatment for a child with a first-degree burn is the application of cool, moist compresses. This helps in reducing pain and swelling without causing further damage to the skin. Applying ice directly to a burn can lead to frostbite and worsen the injury (Choice A). Oral antibiotics are not necessary for first-degree burns as they do not typically involve infection (Choice B). Hot packs should be avoided as they can further damage the skin and increase inflammation (Choice D).

4. What is a key sign of meningitis in an infant?

• A. Increased appetite
• B. Bulging fontanel
• C. Decreased respiratory rate
• D. Elevated blood pressure

Correct answer: B

Rationale: A bulging fontanel is a key sign of meningitis in infants, indicating increased intracranial pressure due to inflammation of the meninges. This can lead to the fontanel bulging. Choices A, C, and D are incorrect. Increased appetite is not typically associated with meningitis in infants; instead, they may have poor feeding. A decreased respiratory rate is not a common sign of meningitis in infants. Elevated blood pressure is also not a typical finding in infants with meningitis.

5. 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.

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