Nokea
A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family the nurse should:
- A. Advise the family to bring the child to the hospital the night before.
- B. Explain that the child will need a large bandage after the procedure.
- C. Discourage bringing favorite toys that might become associated with pain.
- D. Explain that the child may get up as soon as the vital signs are stable.
Correct Answer: B
Rationale: The catheter insertion site will be covered with a bandage. This is important for preschool children to know as they are very concerned about bodily harm. Preparing the child the night before, bringing favorite toys, and explaining activity restrictions are also important but not the primary focus of this choice.
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A nurse who witnesses an accident involving an adolescent riding a motorcycle, hitting a tree, and being thrown 30 feet into a field stops to help. The adolescent reports that he is now unable to move his legs. While waiting for the emergency medical service to arrive, what should the nurse do?
- A. Flex the adolescent's knees to relieve stress on his back.
- B. Leave the adolescent as he is, staying close by.
- C. Remove the adolescent's helmet as soon as possible.
- D. Assess the adolescent for abdominal trauma.
Correct Answer: B
Rationale: Immobilizing the adolescent by leaving him undisturbed prevents further spinal cord damage until EMS arrives.
After emphasizing to an adolescent with renal failure the importance of maintaining a positive self-concept, which of the following behaviors by the adolescent should the nurse identify as an indicator that the plan is working?
- A. Reports of headaches, abdominal pain, and nausea.
- B. Insistence on making diet choices even if the foods chosen are restricted.
- C. Verbalization of plans to quit all after-school activities when returning home.
- D. Demonstration of desire to do the dressing changes and take care of the medications.
Correct Answer: D
Rationale: Self-care indicates positive adjustment.
A 5-year-old child brought to the clinic with several superficial sores on the front of the left leg is diagnosed with impetigo. Which of the following instructions should the nurse give the parent?
- A. Wash the child's legs gently three times per day with a mild soap.
- B. Cover the sores with loose gauze.
- C. Add the child to go back to school after 24 hours of treatment.
- D. Have the child return to the clinic the next week for a follow-up examination.
Correct Answer: C
Rationale: Impetigo is contagious until treated for 24 hours with antibiotics, after which the child can return to school. Gentle washing is helpful but not the primary instruction, gauze may trap moisture, and follow-up timing depends on response.
After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetes still has a fasting blood glucose level of 140 mg/dL. The primary care provider has decided to begin metformin (Glucophage). The adolescent asks how the medication works. The nurse should tell the client that the medicine decreases the glucose production and:
- A. Replaces natural insulin.
- B. Helps the body make more insulin.
- C. Increases insulin sensitivity.
- D. Decreases carbohydrate adsorption.
Correct Answer: C
Rationale: Metformin reduces hepatic glucose production and increases insulin sensitivity in peripheral tissues, improving glucose uptake. It does not replace insulin, stimulate insulin production, or affect carbohydrate absorption.
Parents bring their child to the emergency department because the child has stopped breathing. A nurse obtains a brief history of events occurring before and after the parents found the infant not breathing. Which of the following questions should the nurse ask the parents first?
- A. Was the infant sleeping while wrapped in a blanket?
- B. Was the infant lying on his stomach?
- C. What did the infant look like when you found him?
- D. When had you last checked on the infant?
Correct Answer: B
Rationale: Asking if the infant was lying on his stomach is critical, as prone sleeping is a major risk factor for SIDS and could explain the cessation of breathing.