Nursing Elites

1. What is the therapeutic intervention that provides the best chance of survival for a child with cirrhosis?

• A. Nutritional support
• B. Liver transplantation
• C. Blood component therapy
• D. Treatment with corticosteroids

Correct answer: B

Rationale: Liver transplantation offers the best chance of survival for children with cirrhosis, especially in advanced stages where the liver can no longer function effectively. Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. While nutritional support, blood component therapy, and corticosteroids may be part of the treatment plan to manage symptoms and complications, they do not address the underlying cause of cirrhosis or provide a cure like liver transplantation does.

2. Which intervention is the most appropriate recommendation for relief of teething pain?

• A. Rub gums with aspirin to relieve inflammation
• B. Apply hydrogen peroxide to gums to relieve irritation
• C. Give the infant a frozen teething ring to relieve inflammation
• D. Have the infant chew on a warm teething ring to encourage tooth eruption

Correct answer: C

Rationale: A frozen teething ring is effective for relieving teething pain as the cold helps numb the gums and reduce inflammation, making it a safe and effective method for managing discomfort

3. What is the first step in managing a child with anaphylaxis?

• A. Administer antihistamines
• B. Establish IV access
• C. Administer epinephrine
• D. Monitor vital signs

Correct answer: C

Rationale: The correct answer is to administer epinephrine. Administering epinephrine is the crucial first step in managing anaphylaxis as it helps reverse the severe allergic reaction by constricting blood vessels and relaxing airway muscles, preventing a life-threatening situation. Antihistamines (Choice A) are not the first-line treatment for anaphylaxis and should not delay the administration of epinephrine. Establishing IV access (Choice B) may be necessary but is not the initial step in managing anaphylaxis. Monitoring vital signs (Choice D) is important but should not take precedence over administering epinephrine in the acute management of anaphylaxis.

4. What factor predisposes an infant to fluid imbalances?

• A. Decreased surface area
• B. Lower metabolic rate
• C. Immature kidney functioning
• D. Decreased daily exchange of extracellular fluid

Correct answer: C

Rationale: Infants have immature kidneys that are less efficient at concentrating urine, making them more susceptible to fluid imbalances. Their higher surface area to volume ratio also contributes to greater insensible fluid losses.

5. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

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