Nokea
A 5-year-old child with burns on the trunk and arms has no appetite. The nurse and mother develop a plan of care to stimulate the child's appetite. Which of the following suggestions made by the mother would indicate that she needs additional teaching?
- A. Deciding that she will feed the child herself.
- B. Withholding dessert and treats unless meals are eaten.
- C. Offering the child finger foods that the child likes.
- D. Serving smaller and more frequent meals.
Correct Answer: B
Rationale: Withholding desserts can create negative associations with eating, reducing appetite. Feeding assistance, finger foods, and smaller meals are appropriate to encourage intake in a burn patient with high metabolic needs.
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Which of the following actions initiated by the parents of an 8-month-old indicates they need further teaching about preventing childhood accidents?
- A. Placing a fire screen in front of the fireplace.
- B. Placing a car seat in a front-seat, front-facing position.
- C. Inspecting toys for loose parts.
- D. Placing toxic substances out of reach or in a locked cabinet.
Correct Answer: B
Rationale: A front-seat, front-facing car seat is unsafe for an 8-month-old; rear-facing in the back seat is recommended.
The mother asks the nurse whether her child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which of the following responses by the nurse would be most appropriate?
- A. Ask the doctor what he thinks at your next appointment.'
- B. Maybe, maybe not. How old were you when you first walked?'
- C. It's difficult to predict, but his ability to bear weight is a positive factor.'
- D. If he really wants to walk, and works hard, he probably will eventually.'
Correct Answer: C
Rationale: The ability to bear weight is a positive sign, but predicting normal walking is challenging due to the variability in cerebral palsy outcomes.
Which of the following beverages should the nurse plan to give a child with leukemia to relieve nausea?
- A. Orange juice.
- B. Weak tea.
- C. Plain water.
- D. A carbonated beverage.
Correct Answer: B
Rationale: Weak tea is gentle and soothing, helping relieve nausea without irritation. Other options may worsen nausea.
A nurse is assessing an 8-year-old with diabetes who is experiencing hyperglycemia. Which symptom[s] indicate(s) that the hyperglycemia requires immediate intervention? Select all that apply.
- A. Weakness.
- B. Thirst.
- C. Shakiness.
- D. Hunger.
- E. Headache.
- F. Irritability.
- G. Dizziness.
Correct Answer: B,E,F
Rationale: Thirst, headache, and irritability are hallmark symptoms of hyperglycemia progressing to diabetic ketoacidosis, requiring immediate intervention. Weakness, shakiness, hunger, and dizziness suggest hypoglycemia instead.
When teaching the parents of an older infant with cystic fibrosis (CF) about the type of diet the child should consume, which of the following would be appropriate?
- A. Low-protein diet.
- B. High-fat diet.
- C. Low-carbohydrate diet.
- D. High-calorie diet.
Correct Answer: D
Rationale: A high-calorie diet is appropriate for an infant with cystic fibrosis to meet increased energy needs due to malabsorption and chronic respiratory issues.