Nursing Elites

1. What is the most important intervention in the management of a child with sickle cell crisis?

• A. Administration of iron supplements
• B. Initiation of high-calorie diet
• C. Administration of pain relief
• D. Limiting fluid intake

Correct answer: C

Rationale: The most important intervention in managing a child with sickle cell crisis is the administration of pain relief. During a sickle cell crisis, severe pain is a prominent symptom due to vaso-occlusive episodes. Effective pain management, along with adequate hydration and oxygen therapy, is crucial in treating a sickle cell crisis and preventing further complications. Choice A, the administration of iron supplements, is not the priority during a sickle cell crisis. Iron supplements are typically used to manage anemia in individuals with sickle cell disease but are not the primary intervention during a crisis. Choice B, the initiation of a high-calorie diet, is not the most critical intervention during a sickle cell crisis. While proper nutrition is important in managing sickle cell disease, it is not the immediate priority during a crisis. Choice D, limiting fluid intake, is not recommended during a sickle cell crisis. Hydration is essential in managing sickle cell crisis to prevent complications like dehydration and further vaso-occlusive episodes.

2. The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product?

• A. Tinnitus
• B. Disorientation
• C. Stupor, lethargy, and coma
• D. Edema of the lips, tongue, and pharynx

Correct answer: D

Rationale: Edema of the lips, tongue, and pharynx is a characteristic sign of corrosive poisoning, indicating damage to mucous membranes from ingestion of a caustic substance. Other symptoms may vary depending on the poison but are not as specific to corrosive ingestion.

3. What is the primary symptom of congenital diaphragmatic hernia in a newborn?

• A. Cyanosis
• B. Bradycardia
• C. Absent breath sounds
• D. Tachypnea

Correct answer: C

Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.

4. Which inpatient pediatric patient would not be able to go to the playroom due to their physical condition?

• A. A 4-year-old with chickenpox
• B. A 12-year-old with a fractured femur
• C. A 7-year-old with new-onset diabetes mellitus
• D. A 10-year-old postoperative appendectomy

Correct answer: A

Rationale: The correct answer is A. A child with chickenpox should not go to the playroom due to being contagious, as the virus can easily spread to other children. Children with fractures (choice B), new-onset diabetes mellitus (choice C), or postoperative appendectomy (choice D) do not pose a risk of spreading an infectious disease, so they can safely go to the playroom.

5. What is the narrowing of the preputial opening of the foreskin called?

• A. Chordee
• B. Phimosis
• C. Epispadias
• D. Hypospadias

Correct answer: B

Rationale: Phimosis is the condition where the foreskin cannot be fully retracted over the glans penis due to a narrowing of the preputial opening. Chordee, epispadias, and hypospadias are different conditions involving the penis's structure.

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