Nokea
A child undergoes rehydration therapy after having severe gastroenteritis. After teaching the parents about dietary management, the nurse understands that the teaching plan has been successful when the parents tell the nurse that they will follow which type of diet?
- A. Regular.
- B. Clear liquid.
- C. Full liquid.
- D. Soft.
Correct Answer: D
Rationale: A soft diet is appropriate post-rehydration to ease digestion.
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An adolescent with insulin-dependent diabetes is being taught the importance of rotating the sites of insulin injections. The nurse should judge that the teaching was successful when the adolescent identifies which of the following as a result of using the same site?
- A. Unstruction of the fat tissue and poor absorption.
- B. Destruction of nerves and painful neuritis.
- C. Destruction of the tissue and too-rapid insulin uptake.
- D. Development of resistance to insulin and need for increased amounts.
Correct Answer: A
Rationale: Repeated injections at the same site cause lipodystrophy, leading to poor insulin absorption. Nerve damage, rapid uptake, or insulin resistance are not primary consequences.
A nasogastric tube is ordered to be inserted for a child with severe head trauma. Diagnostic testing reveals that the child has a basilar skull fracture. What should the nurse do next?
- A. Ask for the order to be changed to oral gastric tube.
- B. Attempt to place the tube into the duodenum.
- C. Test the gastric aspirate for blood.
- D. Use extra lubrication when inserting the nasogastric tube.
Correct Answer: A
Rationale: Basilar skull fractures contraindicate NG tube insertion due to the risk of cranial penetration; an oral gastric tube is safer.
The parents report that their 1-day-old is drooling and having choking episodes with excessive amounts of mucus and color changes, especially during feedings. When contacting the physician about these symptoms the nurse should request:
- A. A referral to a lactation consultant.
- B. That the physician further assess the client.
- C. An order for an x-ray with orogastric catheter placement.
- D. A serum blood glucose level per laboratory.
Correct Answer: C
Rationale: These symptoms suggest tracheoesophageal fistula, and an x-ray with orogastric catheter placement can confirm the diagnosis by visualizing the anatomy.
A male adolescent who underwent repair of an inguinal hernia earlier today and is getting ready to go home receives instructions about resuming physical activities. Which of the following statements would indicate that he has understood the instructions?
- A. I can start riding my bike next week.
- B. I have to skip physical education classes for 2 weeks.
- C. I can start wrestling again in 3 weeks.
- D. I can return to my weight-lifting class in 2 weeks.
Correct Answer: B
Rationale: Avoiding strenuous activities like PE for 2 weeks prevents strain on the surgical site.
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.