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The child is hospitalized with dehydration and is receiving IV fluids. What is the best indicator that the child's dehydration is improving?
- A. The child's urine output increases
- B. The child's skin turgor is normal
- C. The child's weight increases
- D. The child's vital signs are stable
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A 7-year-old child with leukemia is receiving chemotherapy. The mother asks the practical nurse (PN) how to manage the child's nausea at home. What advice should the PN provide?
- A. Provide small, frequent meals.
- B. Encourage the child to eat spicy foods.
- C. Offer large meals less frequently.
- D. Allow the child to eat whatever they want.
Correct Answer: A
Rationale: During chemotherapy, children may experience nausea. Providing small, frequent meals can help manage nausea as they are easier to tolerate, reducing the likelihood of vomiting. It is important to offer bland, non-spicy foods to avoid exacerbating nausea. Encouraging large meals less frequently or allowing the child to eat whatever they want may overwhelm the digestive system and worsen nausea.
A 6-month-old female is scheduled to receive diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP) and IPV (inactivated poliovirus vaccine) immunizations. She is recovering from a cold but is otherwise healthy and afebrile. Her 5-year-old sister is receiving chemotherapy. Which considerations should the nurse make for this situation?
- A. DTaP and IPV can be safely given to the infant at the scheduled time.
- B. DTaP and IPV are contraindicated because the infant has a cold.
- C. IPV is contraindicated because her sister is immunocompromised.
- D. DTaP is contraindicated because her sister is immunocompromised.
Correct Answer: A
Rationale: DTaP and IPV can be safely administered to a child with a mild illness like a cold, even if there is an immunocompromised family member, as these vaccines do not contain live viruses. It is important to ensure that the child is otherwise healthy and afebrile before administering the vaccines. The presence of a cold is not a contraindication for receiving DTaP and IPV vaccines.
A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct Answer: D
Rationale: The most important information for the nurse to obtain in this scenario is how often the MDI is used daily. This is crucial to assess if the symptoms the student is experiencing, such as insomnia, shakiness, and tachycardia, could be related to overuse of the inhaler. Overuse of albuterol can lead to side effects like tremors, palpitations, and difficulty sleeping, so understanding the frequency of MDI use is key in determining a potential cause for the student's symptoms.
Which nursing diagnosis is a priority for a 4-year-old child diagnosed with nephrotic syndrome?
- A. Impaired urinary elimination.
- B. Risk for infection.
- C. Fluid volume excess.
- D. Risk for impaired skin integrity.
Correct Answer: C
Rationale: In a child with nephrotic syndrome, fluid volume excess is a priority nursing diagnosis due to the risk of edema and related complications. This patient may experience significant fluid retention, leading to edema, hypertension, and potential respiratory distress. Monitoring and managing fluid volume excess are crucial in preventing further complications and supporting the child's health during nephrotic syndrome.
What action should the nurse implement when the infusion is complete for a 16-year-old with acute myelocytic leukemia receiving chemotherapy via an implanted medication port at the outpatient oncology clinic?
- A. Administer Zofran
- B. Obtain blood samples for RBCs, WBCs, and platelets
- C. Flush the mediport with saline and heparin solution
- D. Initiate an infusion of normal saline
Correct Answer: C
Rationale: After completing the chemotherapy infusion via the implanted medication port, the nurse should flush the mediport with saline and heparin solution. This action helps prevent clot formation in the port, ensuring its patency for future use and reducing the risk of complications associated with catheter occlusion.