Nokea
What response should the practical nurse (PN) provide when a school-age child asks to talk with a dying sister?
- A. Talk loudly to ensure the dying person hears and recognizes others' voices.
- B. Touch can provide a tactile presence if the dying person does not respond to words.
- C. Sitting close offers the dying person the sensation of others' presence.
- D. Although the dying person may not respond, they can still hear what is said.
Correct Answer: D
Rationale: The correct response is D because it is believed that hearing is the last sense to go. Even if the dying person does not respond, speaking to them can still provide comfort. Choice A is incorrect because talking loudly is not necessary and can be distressing. Choice B is incorrect as it focuses on touch rather than the sense of hearing. Choice C is incorrect because sitting close may not necessarily help the dying person hear better.
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A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement?
- A. Obtain a specimen for blood cultures.
- B. Assess the CBC.
- C. Monitor the oral temperature every hour.
- D. Administer acetaminophen as prescribed.
Correct Answer: A
Rationale: Obtaining a specimen for blood cultures is crucial in this situation as it helps identify the source of infection, if present, and guide appropriate treatment. This is important in a child with leukemia receiving chemotherapy to prevent potential complications and ensure timely intervention. Assessing the CBC may provide overall information on the child's condition but may not specifically identify a potential infection. Monitoring the oral temperature is important but obtaining blood cultures takes precedence in this scenario. Administering acetaminophen can help reduce fever but does not address the need to identify a possible infection source.
The healthcare provider is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?
- A. Laughs readily, turns from back to side.
- B. Has strong Moro and tonic neck reflexes.
- C. Keeps fists clenched, opens hands when grasping an object.
- D. Can lift head, but not chest when lying on abdomen.
Correct Answer: A
Rationale: The ability to laugh readily and turn from back to side indicates the effectiveness of thyroid therapy and normal development in a 5-month-old. These behaviors suggest improved muscle tone and motor skills, which are positive outcomes of thyroid hormone replacement therapy for hypothyroidism. Choices B, C, and D describe developmental milestones that are not specific indicators of the effectiveness of thyroid therapy in treating hypothyroidism in a 5-month-old.
A male infant with bronchiolitis is brought to the clinic by his mother. The infant is congested and febrile with a capillary refill of 2 seconds. Which information should the nurse discuss with the mother?
- A. Encourage the infant to play
- B. Limit the amount of oral intake
- C. Keep the infant isolated from others
- D. Place the infant on their back for naps
Correct Answer: C
Rationale: Bronchiolitis is a highly contagious respiratory infection commonly caused by viruses. Isolating the infant from others is crucial to prevent the spread of the infection to other vulnerable individuals, especially those with weakened immune systems. Encouraging play may not be appropriate as the infant is sick and needs rest. Limiting oral intake might be necessary if the infant is having difficulty swallowing due to respiratory distress. Placing the infant on their back for naps is a safe sleep practice but not the priority in this situation where preventing transmission of the infection is crucial.
The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take?
- A. Document the finding
- B. Palpate scrotum for testicular descent
- C. Assess for bladder distension
- D. Auscultate bowel sounds
Correct Answer: A
Rationale: The correct action for the nurse to take in this situation is to document the finding. The infant voiding a urinary stream from the ventral surface of the penis suggests hypospadias, a condition where the urethral opening is on the underside of the penis. This finding is crucial information that needs to be documented for further evaluation. Palpating the scrotum for testicular descent, assessing for bladder distension, and auscultating bowel sounds are not appropriate actions based on the presented scenario and do not address the specific concern of the urinary stream location.
When a 3-year-old boy asks a nurse why his baby sister is eating his mommy's breast, how should the nurse respond? (Select the response that does not apply.)
- A. Remind him that his mother breastfed him too
- B. Clarify that breastfeeding is the mother's choice
- C. Reassure the older brother that it does not hurt his mother
- D. Explain that newborns get milk from their mothers in this way
Correct Answer: A
Rationale: In this scenario, the nurse should avoid reminding the older sibling about his own breastfeeding experience as it does not directly address the question posed by the boy. Providing simple explanations about breastfeeding and newborn feeding patterns helps the older sibling understand the natural process without bringing up personal experiences. Choice B is correct because clarifying that breastfeeding is the mother's choice helps the older sibling understand the concept of personal decisions. Choice C is appropriate as reassuring the older brother that it does not hurt his mother addresses a common concern children may have. Choice D is also suitable as it explains in simple terms how newborns receive milk from their mothers.