Nursing Elites

1. Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?

• A. Meperidine (Demerol)
• B. Morphine
• C. Acetaminophen (Tylenol)
• D. Ibuprofen (Motrin)

Correct answer: B

Rationale: In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.

2. Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?

• A. Autosomal dominant disorder in which the blood clotting factors are deficient.
• B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
• C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
• D. Autosomal recessive disorder in which the blood clotting factors are deficient.

Correct answer: B

Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.

3. What test is used to screen for carbohydrate malabsorption?

• A. Stool pH
• B. Urine ketones
• C. C urea breath test
• D. ELISA stool assay

Correct answer: A

Rationale: Stool pH testing is used to screen for carbohydrate malabsorption. A low pH indicates the presence of unabsorbed carbohydrates, which are fermented by bacteria, leading to acidic stool.

4. A child is admitted with renal failure. Which of these findings should the nurse expect?

• A. Decreased BUN
• B. Azotemia and oliguria
• C. Increased glomerular filtration rate (GFR)
• D. Polyuria and elevated creatinine clearance

Correct answer: B

Rationale: Azotemia (elevated BUN and creatinine) and oliguria (reduced urine output) are classic signs of renal failure, indicating impaired kidney function. In renal failure, the kidneys are unable to effectively filter waste products, leading to an increase in BUN and creatinine levels in the blood. Additionally, oliguria occurs due to decreased kidney function. Increased GFR (Choice C) is not expected in renal failure as it signifies improved kidney function, which is not the case in renal failure. Polyuria and elevated creatinine clearance (Choice D) are not typical findings in renal failure. Polyuria is more commonly associated with conditions like diabetes insipidus, while elevated creatinine clearance would indicate increased kidney function, which is contrary to the impaired function seen in renal failure.

5. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply?

• A. The antibiotic therapy contributes to labile blood pressure values.
• B. Hypotension leading to sudden shock can develop at any time.
• C. Acute hypertension is a concern that requires monitoring.
• D. Blood pressure fluctuations indicate that the condition has become chronic.

Correct answer: C

Rationale: Acute hypertension is a common complication of acute glomerulonephritis, requiring frequent monitoring to prevent complications such as encephalopathy or heart failure. Blood pressure fluctuations can occur but are not necessarily indicative of chronic disease.

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