Nokea
A 9-month-old infant with eczema has lesions that are secondarily infected. Which of the following is most appropriate to help the parents best meet the needs of the child?
- A. Preventing siblings from being in close contact.
- B. Sending the child to day care as usual.
- C. Playing video games for several hours each evening.
- D. Playing with the child every day.
Correct Answer: D
Rationale: Playing with the child daily promotes emotional bonding and normal development, which is critical for a 9-month-old. Preventing sibling contact is unnecessary unless siblings are ill, day care may risk further infection, and video games are inappropriate for an infant.
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Which of the following would indicate that an infant with a tracheoesophageal fistula (TEF) needs suctioning?
- A. Brassy cough.
- B. Substernal retractions.
- C. Decreased activity level.
- D. Increased respiratory rate.
Correct Answer: B
Rationale: Substernal retractions indicate respiratory distress, often due to mucus accumulation in TEF, necessitating suctioning.
The nurse is assisting another member of the health care team who is placing a peripherally inserted catheter in a 10-year-old with peritonitis from a ruptured appendix. The family is present in the treatment room to support the child. The nurse observes the other team member has contaminated a sterile glove. The nurse should:
- A. Discuss the incident with the team member after the event.
- B. Report the incident to the nursing unit manager.
- C. Tell the team member the glove is contaminated.
- D. Ask the family to leave before confronting the team member.
Correct Answer: C
Rationale: Immediately addressing the contamination maintains sterility and patient safety.
After teaching the parent of an infant who has had a surgical repair for a cleft lip about the use of elbow restraints at home, the nurse determines that the teaching has been successful when the parent states which of the following?
- A. We will keep the restraints on continuously except when checking the skin under them for redness.
- B. We will keep the restraints on during the day while he is awake, but take them off when we put him to bed at night.
- C. After we get home, we won't have to use the restraints because our child does not suck on his thumb.
- D. We will be sure to keep the restraints on all the time until we come to see the physician for a follow-up visit.
Correct Answer: A
Rationale: Elbow restraints should be worn continuously but removed periodically to check for skin irritation, ensuring both safety and comfort.
Twelve hours after cardiac surgery, the nurse is assessing a 3-year-old who weighs 15 kg. The nurse should notify the surgeon about which of the following clinical finding?
- A. A urine output of 60 mL in 4 hours.
Correct Answer: A
Rationale: urine output of 60 mL in 4 hours is adequate (1 mL/kg/hr for a 15-kg child is 15 mL/hr, or 60 mL in 4 hours). No other findings are provided, so no notification is needed.
When teaching the parents of an infant how to perform back slaps to dislodge a foreign body, which of the following should the nurse tell the parents to use to deliver the blows?
- A. Palm of the hand.
- B. Heel of the hand.
- C. Fingertips.
- D. Entire hand.
Correct Answer: B
Rationale: The heel of the hand is used to deliver back slaps in infants to effectively dislodge a foreign body without causing injury.