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A 14-year-old was brought to the school nurse's office due to a reported suicide threat. Which one of the following findings puts the patient at the greatest risk for suicide completion?
- A. History of suicide attempt
- B. History of drug and alcohol use
- C. History of divorced parents
- D. Bisexual orientation
Correct Answer: A
Rationale: The correct answer is A: History of suicide attempt. This finding puts the patient at the greatest risk for suicide completion because individuals with a history of suicide attempts are more likely to attempt suicide again. This indicates underlying mental health issues and distress, increasing the risk of completing suicide. Choice B is incorrect as drug and alcohol use is a risk factor but not as strong as a previous suicide attempt. Choices C and D are not direct risk factors for suicide completion.
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A nurse is caring for a newborn whose mother was taking methadone during her pregnancy, which of the following findings indicates the newborn is experiencing withdrawal?
- A. Bulging fontanels
- B. Acrocyanosis
- C. Bradycardia
- D. Hypertonicity
Correct Answer: D
Rationale: The correct answer is D: Hypertonicity. Newborns exposed to opioids in utero often exhibit symptoms of withdrawal, known as Neonatal Abstinence Syndrome (NAS). Hypertonicity, or increased muscle tone, is a common sign of NAS. This occurs due to the withdrawal effects of methadone on the central nervous system. Bulging fontanels (A) are not typically associated with NAS. Acrocyanosis (B) is a common finding in newborns and not specific to NAS. Bradycardia (C) refers to a slow heart rate and is not a typical sign of NAS.
A nurse is caring for a school-age child who is postoperative and received morphine via IV bolus for pain 10 min ago. Which of the following findings is the nurse's priority?
- A. Constipation
- B. Sedation
- C. Bradypnea
- D. Euphoria
Correct Answer: C
Rationale: The correct answer is C: Bradypnea. This is the priority finding because morphine, an opioid, can cause respiratory depression leading to bradypnea or slow breathing. Monitoring the child's respiratory status is crucial to prevent respiratory compromise or arrest. A: Constipation is a common side effect but not an immediate concern. B: Sedation is expected after receiving morphine but not as critical as respiratory depression. D: Euphoria is a possible side effect but not as concerning as respiratory depression. Thus, the priority is to monitor for signs of respiratory depression to ensure the child's safety.
Which are appropriate actions to manage a hospitalized child with hemophilia? (Select all that apply).
- A. Administer Factor VII for bleeding crises
- B. Administer platelets for bleeding crises
- C. Avoid unnecessary skin punctures
- D. Administer Ibuprofen for complaints of discomfort
Correct Answer: A,C
Rationale: The correct answers are A and C. Administering Factor VII helps in managing bleeding crises in hemophiliac patients. Factor VII aids in clotting, essential for stopping bleeding. Avoiding unnecessary skin punctures reduces the risk of bleeding episodes in hemophilia patients. Platelets (B) and Ibuprofen (D) are not appropriate for managing hemophilia. Platelets do not address the underlying clotting factor deficiency in hemophilia, and Ibuprofen can worsen bleeding due to its antiplatelet effects.
A nurse is instructing a school-age child who has asthma about the use of a peak expiratory flow meter. Which of the following instructions should the nurse include?
- A. Place tongue on the mouthpiece of the meter.
- B. Maintain a semi-Fowler's position during testing.
- C. Record the average of the readings.
- D. Blow into the meter as hard and quickly as possible.
Correct Answer: D
Rationale: The correct answer is D: Blow into the meter as hard and quickly as possible. This instruction is correct because when using a peak expiratory flow meter, the individual needs to blow out as forcefully as possible to get an accurate reading of their peak expiratory flow rate. This helps in assessing the severity of asthma symptoms and monitoring the effectiveness of treatment.
A: Placing the tongue on the mouthpiece is incorrect as it may interfere with the airflow and affect the accuracy of the reading.
B: Maintaining a semi-Fowler's position is not necessary for using a peak flow meter.
C: Recording the average of the readings is not typically done with peak flow meters as the focus is on the individual's peak expiratory flow rate.
E, F, G: No other choices were provided.
In summary, blowing into the meter as hard and quickly as possible is the correct instruction for using a peak expiratory flow meter, as it ensures an accurate measurement of peak expir
When instructing the parents of a toddler with iron deficiency anemia about the importance of increasing iron in the toddler's diet, which of the following foods should the nurse instruct the parents to include in the toddler's diet?
- A. Pasta
- B. Vitamin D milk
- C. Dried fruits
- D. Green leafy vegetables
Correct Answer: C
Rationale: The correct answer is C: Dried fruits. Dried fruits are a good source of iron, which is essential for treating iron deficiency anemia in toddlers. They provide a concentrated amount of iron in a small serving size, making them convenient for toddlers. Pasta (A) does not contain significant amounts of iron. Vitamin D milk (B) is important for bone health but does not provide a substantial amount of iron. Green leafy vegetables (D) are a good source of iron, but they may be harder for toddlers to eat compared to dried fruits.