Nokea
A 17-year-old female with severe nodular acne is considering treatment with isotretinoin (Accutane). Prior to beginning the medication, the nurse explains that the client will be required to:
- A. Enroll in a risk management plan.
- B. Egypt in a risk management plan.
- C. Begin an effective form of birth control.
- D. Temporarily give up sports.
Correct Answer: C
Rationale: Isotretinoin has a high risk of teratogenicity, requiring strict contraception to prevent pregnancy during treatment. A risk management plan (e.g., iPLEDGE) is also required, but the most critical initial step emphasized is effective birth control.
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The nurse observes as a child with Duchenne's muscular dystrophy attempts to use from a sitting position on the floor. After attaining a kneeling position, the child 'walks' his hands up his legs to stand. The nurse documents this as which of the following?
- A. Galeazzi's sign.
- B. Goodell's sign.
- C. Goodenough's sign.
- D. Gower's sign.
Correct Answer: D
Rationale: Gower's sign is characteristic of Duchenne's muscular dystrophy, indicating proximal muscle weakness as the child uses their hands to 'walk' up their legs to stand.
After a child undergoes nephrectomy for a Wilms' tumor, the nurse should assess the child postoperatively for which early sign of a complication?
- A. Increased abdominal distention.
- B. Elevated blood pressure.
- C. Increased respiratory rate.
- D. Increased urine output.
Correct Answer: A
Rationale: Distention suggests internal bleeding.
A child who limps and has pain has been found to have Legg-Calvé-Perthes disease. What should the nurse expect to include in the child's plan of care?
- A. Initiation of pain control measures, especially at night when acute.
- B. Promotion of ambulation despite child's discomfort in the affected hip.
- C. Prevention of flexion in the affected hip and knee.
- D. Advance of weight bearing on the head of the affected femur.
Correct Answer: A
Rationale: Pain control is essential in Legg-Calvé-Perthes disease, as pain is a common symptom, especially at night, due to inflammation and muscle spasms.
When obtaining a history from the parents of a child diagnosed with diarrhea due to Salmonella, the nurse should ask the parents if the child has been exposed to which of the following possible sources of infection?
- A. Nonrefrigerated custard.
- B. A pet canary.
- C. Undercooked eggs.
- D. Unwashed fruit.
Correct Answer: C
Rationale: Undercooked eggs are a common source of Salmonella infection.
An infant is to be discharged after surgery for intussusception. In developing the discharge teaching plan, the nurse should tell the mother?
- A. The infant will experience a change in the normal home routine.
- B. The infant can return to the prehospital routine immediately.
- C. The infant needs to ingest more calories at home than normal.
- D. The infant will continue to experience abdominal cramping for a few days.
Correct Answer: B
Rationale: After successful surgery, the infant can typically resume normal routines unless complications arise.