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 an important dietary consideration for a child with cystic fibrosis?

• A. High-calorie, high-fat diet
• B. Low-sugar diet
• C. Increased dietary fiber
• D. High-sodium diet

Correct answer: A

Rationale: For a child with cystic fibrosis, an important dietary consideration is a high-calorie, high-fat diet. This type of diet helps address malabsorption issues commonly seen in individuals with cystic fibrosis and supports adequate growth and development. High-calorie, high-fat foods are recommended to help meet the increased energy needs of these individuals. Choices B, C, and D are not the most appropriate dietary considerations for a child with cystic fibrosis. A low-sugar diet may not provide enough calories for optimal growth, increased dietary fiber may exacerbate issues related to malabsorption, and a high-sodium diet is generally not recommended due to the risk of dehydration and electrolyte imbalances in individuals with cystic fibrosis.

3. Which lab result should be abnormal in a child with hemophilia?

• A. Prothrombin time
• B. Bleeding time
• C. Platelet count
• D. Partial thromboplastin time

Correct answer: D

Rationale: In a child with hemophilia, the lab result that should be abnormal is the partial thromboplastin time (PTT). Hemophilia is a disorder that affects the clotting factors in the intrinsic pathway of coagulation, leading to a prolonged PTT. Prothrombin time (Choice A) assesses the extrinsic pathway and should be normal in hemophilia. Bleeding time (Choice B) evaluates platelet function, which is typically normal in hemophilia. Platelet count (Choice C) measures the number of platelets and is not directly affected by hemophilia.

4. How should a healthcare professional manage a child with a newly inserted gastrostomy tube?

• A. Monitor for signs of infection
• B. Increase the child's fluid intake
• C. Restrict all oral intake
• D. Use only sterile equipment for feedings

Correct answer: A

Rationale: Monitoring for signs of infection at the gastrostomy site is crucial for ensuring proper care and preventing complications. This involves observing for redness, swelling, warmth, or drainage around the insertion site. Increasing the child's fluid intake (Choice B) may be beneficial for hydration but is not specifically related to managing a newly inserted gastrostomy tube. Restricting all oral intake (Choice C) is not necessary as long as the healthcare professional follows the recommended guidelines for feeding. While using sterile equipment for feedings (Choice D) is important, monitoring for signs of infection takes precedence in the immediate post-insertion period.

5. What is a common sign of a urinary tract infection in older children?

• A. Frequent urination
• B. Increased appetite
• C. Elevated blood pressure
• D. Decreased energy levels

Correct answer: A

Rationale: Frequent urination is a common sign of a urinary tract infection in older children. It is often accompanied by other symptoms such as pain or discomfort. Increased appetite (Choice B) is not typically associated with urinary tract infections. Elevated blood pressure (Choice C) is more commonly linked to conditions like hypertension, not urinary tract infections. Decreased energy levels (Choice D) can be a sign of various health issues but are not a typical symptom of a urinary tract infection.

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