Nokea
A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on which statement?
- A. This is usually benign and temporary.
- B. This is usually caused by Klinefelter syndrome.
- C. Administration of estrogen effectively reduces gynecomastia.
- D. Administration of testosterone effectively reduces gynecomastia.
Correct Answer: A
Rationale: The correct statement is that bilateral breast enlargement in a 14-year-old boy is usually benign and temporary. This condition, known as gynecomastia, is commonly seen during puberty due to hormonal changes. It typically resolves on its own without the need for intervention. It is important for the nurse to reassure the boy and his parents that this is a normal occurrence and should not be a cause for major concern. It is crucial to address any underlying anxieties and provide education on the natural course of puberty-related changes.
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Children with secondary nocturnal enuresis may have
- A. UTI
- B. diabetes mellitus
- C. diabetes insipidus
- D. psychosocial stressor
Correct Answer: D
Rationale: Psychosocial stressors can trigger secondary nocturnal enuresis after a period of dryness.
Which is the most reliable method for monitoring fluid balance?
- A. Daily intake and output
- B. Vital signs
- C. Daily weight
- D. Skin turgor
Correct Answer: A
Rationale: Monitoring daily intake and output is the most reliable method for assessing fluid balance in a patient. By accurately measuring the amount of fluids taken in through foods, drinks, and IV fluids, as well as the amount of fluids eliminated through urine, stool, vomit, and other means, healthcare providers can closely track the body's fluid balance. Discrepancies between intake and output can indicate potential issues such as dehydration or fluid overload. This method provides quantitative data that can guide appropriate interventions and treatment adjustments to maintain the patient's fluid balance within normal limits. While vital signs, daily weight, and skin turgor are also important indicators of fluid status, they may not always provide as specific or accurate information as the direct measurement of intake and output.
Which would be best for the nurse to use when determining the temperature of a preterm infant under a radiant heater?
- A. Axillary sensor TestBankWorld.org
- B. Tympanic membrane sensor
- C. Rectal mercury glass thermometer
- D. Rectal electronic thermometer
Correct Answer: B
Rationale: A tympanic membrane sensor or tympanic thermometer is the best option for determining the temperature of a preterm infant under a radiant heater. Tympanic thermometers are quick and non-invasive, making them ideal for use in neonatal care. They provide accurate readings by measuring the infrared heat waves coming from the eardrum. This method is preferred over other options like axillary sensors, rectal mercury thermometers, and rectal electronic thermometers, which may not be as efficient or suitable for use with preterm infants.
Vitamin A supplementation may be recommended for the young child who has which disease?
- A. Mumps
- B. Rubella
- C. Measles (rubeola)
- D. Erythema infectiosum
Correct Answer: C
Rationale: Vitamin A supplementation may be recommended for children with measles (rubeola) due to the disease's association with vitamin A deficiency. Measles can lead to reduced levels of vitamin A in the body, which can result in increased severity of symptoms, complications, and even death. Supplementing with vitamin A during and after a measles infection helps reduce the risk of complications and mortality, particularly in young children under the age of 5 in areas where vitamin A deficiency is common. Therefore, providing vitamin A supplementation to children with measles is an important intervention to support their recovery and improve outcomes.
Hemangiomas are the most common benign tumors of infancy, occurring more in full-term infants. Of the following, the most common risk factor of development of hemangioma is
- A. male infant
- B. female infant
- C. infant of diabetic mother
- D. infant delivered by cesarean section
Correct Answer: B
Rationale: Female infants are at higher risk for developing hemangiomas.