Nokea
A 15-year-old child is admitted to the pediatric unit with a diagnosis of thalassemia. Which of the following would be included in educating the mother and child as part of discharge planning?
- A. Give oral iron medication every day.
- B. Have the child's blood pressure monitored every week.
- C. Know the signs and symptoms of iron overload.
- D. Keep exercise at a minimum to reduce stress.
Correct Answer: C
Rationale: Oral iron supplements are contraindicated in thalassemia. Although heart failure may be an end result of this disease, this action is unnecessary. Iron overload is a potential complication of frequent blood transfusions of children with thalassemia. Children should be encouraged to pursue activities related to their exercise tolerance.
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A client with a history of a stroke is being taught to use a cane. The nurse should teach the client to:
- A. Hold the cane in the strong hand
- B. Advance the cane with the strong leg
- C. Use the cane on the weak side
- D. Lean heavily on the cane while walking
Correct Answer: C
Rationale: The cane should be used on the weak side to support the affected leg, improving balance and gait post-stroke. Holding it in the strong hand or advancing with the strong leg is incorrect.
In teaching the client about proper umbilical cord care, the nurse recommends that:
- A. Petrolatum be placed around the cord after the sponge bath
- B. A belly binder be applied to prevent umbilical hernia
- C. The area be cleansed at diaper changes with alcohol and inspected for redness or drainage
- D. The cord clamp be left on until the cord stump separates
Correct Answer: C
Rationale: Petrolatum does not allow the cord to dry and will encourage infection. Belly binders do not facilitate drying of the cord and will encourage abdominal relaxation. Frequent applications of alcohol will facilitate drying and discourage infection. The cord clamp can be removed in 24 hours. Leaving it on is cumbersome and could pull on the cord unnecessarily.
Which method of transmission would most likely result in contamination with botulism?
- A. Close contact with a family member with botulism
- B. Eating foods from a perforated can
- C. Being bitten by a mosquito
- D. Wound contamination with C-botulism
- E. Contact with goat saliva
- F. Breathing dust from contaminated cat litter
Correct Answer: B, D
Rationale: Botulism is caused by Clostridium botulinum toxin, typically from contaminated food (e.g., perforated cans, B) or wound contamination (D). It is not transmitted person-to-person (A), via mosquitoes (C), goat saliva (E), or cat litter dust (F).
The nurse is teaching a client with a history of type 2 diabetes about foot care. The nurse should tell the client to:
- A. Inspect feet daily
- B. Soak feet in hot water
- C. Wear tight shoes
- D. Cut toenails with scissors
Correct Answer: A
Rationale: Daily foot inspection helps detect early signs of injury or infection in type 2 diabetes, preventing complications like ulcers.
The nurse is caring for a client with a history of a stroke who has dysphagia. The nurse should:
- A. Offer thin liquids
- B. Position the client upright for meals
- C. Feed the client quickly
- D. Use a straw for fluids
Correct Answer: B
Rationale: Positioning upright during meals reduces aspiration risk in dysphagia post-stroke. Thickened liquids, slow feeding, and avoiding straws are also recommended.