Nokea
A child 2 years 6 months of age has arranged a play date with a neighbor's child aged 2 years 9 months. During the play date, which behavior is most typical for children of this age?
- A. Share and trade toys while playing.
- B. Play with one another with little or no conflict.
- C. Engage in parallel play (playing alongside but not directly with one another).
- D. Play with only one or two items, ignoring most of the other toys.
Correct Answer: C
Rationale: Toddlers typically engage in parallel play rather than cooperative play.
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An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. Provide the answer using lowercase letters separated by commas (e.g., a, b, c, d).
- A. Administer 100% oxygen by blow-by.
- B. Place the infant in knee-chest position.
- C. Remain calm.
- D. Give morphine subcutaneously or by an existing intravenous line.
Correct Answer: B
Rationale: Highest-priority intervention: Place the infant in the knee-chest position. This position can help increase systemic vascular resistance and reduce the shunting of blood from right to left in tetralogy of Fallot, temporarily improving oxygenation.
One of the dangers of treating hypernatremia is:
- A. Red blood cell crenation
- B. Cerebral edema
- C. Red blood cell hydrolysis
- D. Renal shutdown
Correct Answer: B
Rationale: Hypernatremia is a condition characterized by high levels of sodium in the blood. When hypernatremia is treated too rapidly or aggressively, a rapid decrease in serum sodium levels may occur. This rapid change in serum sodium concentration can cause water to move into brain cells, leading to cerebral edema. Cerebral edema is a dangerous complication associated with the potential to cause increased intracranial pressure, neurological deficits, and even death. It is crucial to correct hypernatremia slowly and carefully to prevent such complications.
A 4-year-old weighing 15 kg produces 150 mL of urine in 10 hours. What should the nurse do?
- A. Notify the physician; urine output is too low.
- B. Encourage increased oral intake.
- C. Record the urine output in the chart.
- D. Administer IV fluids to rehydrate.
Correct Answer: C
Rationale: Expected urine output is 0.5-1 mL/kg/hr. For a 15-kg child over 10 hours, 75-150 mL is within normal limits.
Which client statement would indicate to the nurse that the client with polycythemia vera is in need further of instruction?
- A. I'll be flying overseas to see my son and grandchildren for the holidays
- B. I plan to do my leg exercises at least three times a week
- C. I'm going to be walking in the mall everyday to build up my strength
- D. At night when I sleep, I like to use two pillows to raise my head up CARING FOR CLIENTS FOR DISORDERS OF THE LYMPHATIC SYSTEM
Correct Answer: A
Rationale: Clients with polycythemia vera are at an increased risk for developing blood clots due to the increased thickness of their blood. Flying long distances, especially overseas, can further increase this risk. Therefore, traveling long distances by plane can be dangerous for clients with polycythemia vera. The nurse should provide instructions to the client regarding the importance of discussing travel plans with their healthcare provider to ensure appropriate measures are in place to minimize the risk of blood clots.
Mr. Aurelio diagnosed with heart failure, was prescribed with a 2 gm sodium diet. which of the following foods would nurse Norma instruct him to restrict?
- A. whole wheat bread
- B. canned tomato juice
- C. beef tenderloin strips
- D. apples
Correct Answer: B
Rationale: Canned tomato juice is often high in sodium content due to added salt during processing. Since Mr. Aurelio has been prescribed a 2 gm sodium diet, the nurse would instruct him to restrict foods high in sodium content, such as canned tomato juice. Whole wheat bread and apples are generally low in sodium, and beef tenderloin strips can be chosen in lean cuts and prepared without high sodium additives, making them more suitable for Mr. Aurelio's dietary restrictions.