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. What is a long-term complication of cleft lip and palate?

• A. Cognitive impairment
• B. Altered growth and development
• C. Faulty dentition
• D. Physical abilities

Correct answer: C

Rationale: The correct long-term complication of cleft lip and palate is faulty dentition. Individuals with cleft lip and palate may experience dental issues such as missing, extra, or misaligned teeth, which can affect speech and the aesthetic appearance of the mouth. Cognitive impairment, as mentioned in choice A, is not a typical long-term complication associated with cleft lip and palate. While altered growth and development (choice B) can be affected during early stages, it is not a prominent long-term complication. Choice D, physical abilities, is not directly related to the typical long-term complications of cleft lip and palate.

3. How should hydration status in a child with fever and vomiting be assessed?

• A. Monitor skin turgor and mucous membranes
• B. Measure blood glucose levels
• C. Check for signs of jaundice
• D. Assess respiratory rate

Correct answer: A

Rationale: To assess hydration status in a child with fever and vomiting, monitoring skin turgor and mucous membranes is essential. Skin turgor refers to the skin's ability to change shape and return to normal; poor skin turgor can indicate dehydration. Mucous membranes, such as the mouth and eyes, can also provide valuable information about hydration levels. Measuring blood glucose levels (Choice B) is not directly related to assessing hydration status. Checking for signs of jaundice (Choice C) is important for liver-related issues, not hydration assessment. Assessing respiratory rate (Choice D) is crucial for evaluating respiratory function, not hydration status.

4. In what position does the Pavlik harness hold a child's femurs for developmental hip dysplasia?

• A. Abduction
• B. Adduction
• C. Flexion
• D. Extension

Correct answer: A

Rationale: The Pavlik harness is designed to position a child's femurs in abduction for developmental hip dysplasia. Abduction helps align the hip joint correctly and promotes proper development in cases of hip dysplasia. Adduction (choice B) brings the legs closer to the midline, which is not the desired position in this condition. Flexion (choice C) refers to bending at a joint, while extension (choice D) is the opposite of flexion. However, in the case of developmental hip dysplasia, abduction is crucial for the Pavlik harness to work effectively.

5. 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.

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