Nokea
At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?
- A. Developmentally appropriate toys
- B. Nutritious snacks served to the children
- C. Handwashing by providers after diaper changes
- D. Certified caregivers for each of the age groups at the facility
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?
- A. Seizure disorder
- B. Narcotic withdrawal
- C. Placental insufficiency
- D. Meconium aspiration syndrome
Correct Answer: B
Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.
The nurse is conducting discharge teaching to an adolescent with a methicillin-resistant Staphylococcus aureus (MRSA) infection. What should the nurse include in the instructions?
- A. Avoid sharing of towels and washcloths
- B. All are applicable
- C. Use bleach when laundering towels and washcloths
- D. Take a daily bath or shower with an antibacterial soap
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The LPN is assessing for fontanels on the head of a 6-month-old. Which fontanel is expected to still be present?
- A. Posterior
- B. Anterior
- C. Sphenoid
- D. Lambdoid
Correct Answer: B
Rationale: The correct answer is B: Anterior. The anterior fontanel usually remains open until about 12-18 months of age, while the posterior fontanel closes by 2-3 months. Choices A, C, and D are incorrect as the posterior fontanel closes by 2-3 months of age, and the sphenoid and lambdoid fontanels are not typically assessed in routine infant head examinations.
At which age can most infants sit steadily unsupported?
- A. 4 months
- B. 6 months
- C. 8 months
- D. 12 months
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
At what point in the hospitalization of the pediatric patient should discharge planning and teaching begin?
- A. Post-operatively
- B. Right when the patient is being discharged with the parents and support members present
- C. On the morning that the patient is scheduled to go home
- D. On admission
Correct Answer: D
Rationale: Discharge planning should begin on admission to ensure that all necessary teaching and preparations are completed in a timely manner. Starting discharge planning early allows for a comprehensive assessment of the patient's needs, coordination with the healthcare team, and adequate time for patient and family education. Choice A, post-operatively, is too late in the process and may lead to rushed planning. Choice B, right at discharge, may not allow enough time for thorough preparation. Choice C, on the morning of discharge, also does not provide sufficient time for effective planning and education.