Nokea
The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?
- A. Child abuse
- B. Cultural practice to rid the body of disease
- C. Cultural practice to treat enuresis or temper tantrums
- D. Child discipline measure common in the Vietnamese culture
Correct Answer: B
Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.
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A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
- A. Indicative of maladjustment
- B. A common reaction to divorce
- C. Suggestive of a lack of adequate parenting
- D. An unusual response that indicates a need for referral
Correct Answer: B
Rationale: Poor academic performance and sleep disturbances are common reactions in children going through their parents' divorce, reflecting stress and adjustment challenges.
What problem is most often associated with myelomeningocele?
- A. Biliary atresia
- B. Hydrocephalus
- C. Craniostenosis
- D. Tracheoesophageal fistula
Correct Answer: B
Rationale: Hydrocephalus is the most commonly associated problem with myelomeningocele, present in 80% to 90% of affected children. Biliary atresia and tracheoesophageal fistula are not typically associated with myelomeningocele. Craniostenosis refers to the premature closing of cranial sutures and is not a common issue seen with myelomeningocele.
Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
- A. All below
- B. Considering alternative actions
- C. Using formal and informal thinking to gather data
- D. Giving deliberate thought to a patient's problem
Correct Answer: A
Rationale: Clinical reasoning involves deliberate and thoughtful decision-making, considering alternatives, and using both formal and informal data gathering methods to provide optimum care.
Children may believe that they are responsible for their parents' divorce and interpret the separation as punishment. At which age is this most likely to occur?
- A. 1 year
- B. 4 years
- C. 8 years
- D. 13 years
Correct Answer: C
Rationale: At around 8 years old, children may feel they are responsible for their parents' divorce and view it as a punishment, which can impact their emotional well-being.
Which laboratory test would be most important for the nurse to assess when caring for a toddler suspected of having cystic fibrosis?
- A. Liver enzymes
- B. Serum calcium
- C. Sweat chloride test
- D. Urine creatinine
Correct Answer: C
Rationale: The sweat chloride test is the primary diagnostic test for cystic fibrosis. Cystic fibrosis is characterized by abnormal transport of chloride and sodium across epithelial cell membranes, leading to increased chloride in sweat. This test is crucial for diagnosing cystic fibrosis in suspected cases. Liver enzymes (Choice A), serum calcium (Choice B), and urine creatinine (Choice D) are not specific tests for cystic fibrosis and would not provide the necessary information for diagnosis in this case.