Nokea
A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:
- A. An 18-month-old with RSV.
- B. A 9-year-old 8 hours post-appendectomy.
- C. A 1-year-old with a heart defect.
- D. A 6-year-old with sickle cell crisis.
Correct Answer: C
Rationale: Assigning the same nurse to a child with RSV and a 1-year-old with a heart defect should be avoided due to the risk of transmitting RSV, which can be particularly severe in children with cardiac conditions.
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The nurse is assessing a neonate with suspected tracheoesophageal fistula. Which of the following findings would be most concerning?
- A. Excessive drooling.
- B. Mild cyanosis during feeding.
- C. Heart rate of 140 bpm.
- D. Temperature of 37°C.
Correct Answer: B
Rationale: Mild cyanosis during feeding indicates potential airway compromise, a critical concern in TEF.
After the acute stage following an ingestion of drain cleaner by a child, the nurse should be alert for the development of which of the following as a likely complication?
- A. Tracheal stenosis.
- B. Tracheal varices.
- C. Esophageal strictures.
- D. Esophageal diverticula.
Correct Answer: C
Rationale: Corrosive ingestion can scar the esophagus, leading to strictures. Tracheal complications are less common unless the airway is directly affected, and diverticula are not typical.
A client's diagnosis of cystic fibrosis was made 13 years ago, and he has since been hospitalized several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and failure to thrive. Which nursing actions are most important initially?
- A. Placing the client on bed rest and ordering a blood gas analysis.
- B. Ordering a high-calorie, high-protein, low-fat, vitamin-enriched diet and pancreatic granules.
- C. Applying an oximeter and initiating respiratory therapy.
- D. Inserting an I.V. line and initiating antibiotic therapy.
Correct Answer: C
Rationale: Applying an oximeter to assess oxygen saturation and initiating respiratory therapy are critical initial actions to address labored respirations and support respiratory function in a cystic fibrosis patient with acute symptoms.
A 1-year-old child is scheduled for surgery to correct hypospadias and chordee. The nurse explains to the parents that this is the preferred time for surgical repair based on which of the following?
- A. At this age, the child will experience less pain.
- B. The child is too young to have developed castration anxiety.
- C. The child will not remember the surgical experience.
- D. The repair is easier to perform after the child is toilet trained.
Correct Answer: C
Rationale: Younger children may not remember the experience.
A nurse is counseling parents of an obese child. Which lifestyle change should be emphasized?
- A. Eliminate all carbohydrates.
- B. Increase physical activity.
- C. Restrict meals to twice daily.
- D. Use meal replacement shakes.
Correct Answer: B
Rationale: Increased physical activity promotes weight control and health. Eliminating carbohydrates, restricting meals, or using shakes are not sustainable or appropriate for children.