A 12-year-old male has short stature because of a constitutional growth delay. What should the nurse be the most concerned about?
- A. Proper administration of thyroid hormone
- B. Proper administration of human growth hormones
- C. Child's self-esteem and sense of competence
- D. Helping child understand that his height is most likely caused by chronic illness and is not his fault
Correct Answer: C
Rationale: The nurse should be most concerned about the child's self-esteem and sense of competence. A 12-year-old male with short stature due to a constitutional growth delay may experience feelings of inadequacy or embarrassment because of his height. It is important for the nurse to address these emotional aspects of the condition and support the child in developing a positive self-image. By promoting the child's self-esteem and sense of competence, the nurse can help the child navigate any challenges associated with his height and build confidence in his abilities and worth as an individual.
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The nurse understands that which of the ff. is a side effect most likely to be reported by patients receiving enalapril maleate (Vasotec)?
- A. Acne
- B. Diarrhea
- C. Cough
- D. Heartburn
Correct Answer: C
Rationale: The most common side effect reported by patients receiving enalapril maleate (Vasotec) is a persistent dry cough. This cough is due to the medication's effect on bradykinin levels in the body, leading to irritation of the respiratory tract and causing the cough. While other side effects such as diarrhea and heartburn may occur, cough is the most frequently reported side effect associated with enalapril maleate. Acne is not a commonly reported side effect of this medication.
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. What should the nurse recommend the infant be given?
- A. Skim milk
- B. Whole cow's milk
- C. Commercial iron-fortified formula
- D. Commercial formula without iron
Correct Answer: C
Rationale: When a mother decides to discontinue breastfeeding, it is important for the infant to receive an appropriate alternative that provides essential nutrients, including iron. Commercial iron-fortified formula ensures that the infant is receiving adequate iron, which is crucial for healthy growth and development. Skim milk is not recommended for infants under age 1 due to its high protein and mineral content, which can strain the baby's immature kidneys. Whole cow's milk is also not suitable before age 1 because it lacks essential nutrients such as iron and vitamin E, and can lead to iron deficiency anemia. Commercial formula without iron would not provide enough iron for the infant's needs, making commercial iron-fortified formula the most appropriate choice for the 5-month-old infant.
An 18-year-old with a groin rash and itching is worried about having an STD and does not want his parents to know. What should the nurse say?
- A. We will need to contact your parents.
- B. We will not contact your parents regarding this visit.
- C. Who would you like us to contact about your visit today?
- D. We cannot promise that the hospital will not contact your parents.
Correct Answer: B
Rationale: Adolescents have the right to privacy regarding sexual health, unless there is a risk to life.
Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
Which of the following statements would be the nurse's response to a famiiy member asking questions about a client's transient ischemic attack (TIA)?
- A. "I think you should ask the doctor. Would you like me to cail him for you?"
- B. " The blood supply to the brain has decreased causing permanent brain damage."
- C. "It Is a temporary interruption in the blood flow to the brain."
- D. "TIA means a transient ischemic attack."
Correct Answer: C
Rationale: The correct response would be: "It is a temporary interruption in the blood flow to the brain." This response provides a clear and accurate explanation of a transient ischemic attack (TIA), which is commonly known as a "mini-stroke." A TIA is indeed a temporary episode where there is a brief interruption in the blood flow to the brain, leading to symptoms similar to those of a stroke, but without lasting damage. This response would give the family member a better understanding of what a TIA is and help alleviate concerns about permanent brain damage.