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A 7-year-old child with a history of asthma controlled without medications is referred to the school nurse by the teacher because of persistent coughing. Which of the following should the nurse do first?
- A. Obtain the child's heart rate.
- B. Give the child a nebulizer treatment.
- C. Call a parent to obtain more information.
- D. Have a parent come and pick up the child.
Correct Answer: C
Rationale: Calling a parent to obtain more information is the first step to clarify the child's asthma history, recent symptoms, and any prescribed medications, ensuring appropriate management of the persistent coughing.
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The health care team determines that the family of an infant with failure to thrive who is to be discharged will need follow-up care. Which of the following would be the most effective method of follow-up?
- A. Daily phone calls from the hospital nurse.
- B. Enrollment in community parenting classes.
- C. Twice-weekly clinic appointments.
- D. Weekly visits by a community health nurse.
Correct Answer: D
Rationale: Weekly in-home nurse visits provide direct monitoring and support for feeding and growth. Phone calls, classes, or clinic visits are less comprehensive.
When developing the discharge plan for a child who had a nephrectomy for a Wilms' tumor, the nurse identifies outcomes to prevent damage to the child's remaining kidney and accomplish which of the following?
- A. Minimize pain.
- B. Prevent dependent edema.
- C. Prevent urinary tract infection.
- D. Minimize sodium intake.
Correct Answer: C
Rationale: Preventing UTIs protects kidney function.
An 18-month-old with a congenital heart defect is to receive digoxin twice a day. The nurse should instruct the parents about which of the following?
- A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
- B. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances.
- C. Digoxin is absorbed better if taken with meals.
- D. If the child vomits within 15 minutes of administration, the dosage should be repeated.
Correct Answer: A
Rationale: Digoxin improves heart function by increasing contractility and regulating rhythm. Toxicity signs are correct but not the focus here, absorption is not meal-dependent, and repeating a vomited dose risks overdose.
The nurse is caring for a child in Bryant’s traction (see fi gure). The nurse should:
- A. Adjust the weights on the legs until the buttocks rest on the bed.
- B. Provide frequent skin care.
- C. Place a pillow under the buttocks.
- D. Remove the elastic leg wraps every 8 hours for 10 minutes.
Correct Answer: B
Rationale: The traction is positioned correctly; the nurse should provide frequent skin care to the back and shoulder areas. The hips and buttocks should be lifted off the bed to provide counter traction; the nurse should not adjust the weights. The nurse should not place a pillow under the buttocks as this would prevent counter traction. The elastic wraps should remain on the legs unless permitted by the physician.
The nurse is planning care for a child with hemophilia who is scheduled for a dental procedure. Which precaution should the nurse include?
- A. Administer ibuprofen for post-procedure pain.
- B. Schedule the procedure without prior preparation.
- C. Ensure factor replacement therapy is given before the procedure.
- D. Encourage vigorous rinsing of the mouth post-procedure.
Correct Answer: C
Rationale: Factor replacement therapy before dental procedures prevents excessive bleeding in hemophilia. Ibuprofen and vigorous rinsing increase bleeding risk.