Nokea
A child with a nut allergy is admitted with a severe reaction for the third time in three months. The parent says, 'I am having trouble with the food labels.' The nurse should first:
- A. Assess the parent's ability to read.
- B. Refer the client to the dietician.
- C. Notify the primary care provider.
- D. Obtain a social service consult.
Correct Answer: B
Rationale: A dietician can provide expert guidance on reading labels to avoid allergens. Reading assessment, provider notification, or social services may follow but are not the priority.
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After teaching the parents of a preschooler who has undergone a tonsillectomy and adenoidectomy about appropriate foods to give the child after discharge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching?
- A. Meat loaf and uncooked carrots.
- B. Pork and noodle casserole.
- C. Cream of chicken soup and orange sherbet.
- D. Hot dog and potato chips.
Correct Answer: C
Rationale: Cream of chicken soup and orange sherbet are soft, non-irritating foods suitable for a child post-tonsillectomy, as they are easy to swallow and unlikely to irritate the surgical site. Meat loaf, uncooked carrots, pork, noodles, hot dogs, and potato chips are harder or crunchier foods that could irritate or cause discomfort.
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.
The nurse is assisting with conscious sedation for a 6-year-old undergoing a bone marrow biopsy. The nurse's most important responsibility during the procedure is to:
- A. Administer the topical anesthetic.
- B. Keep the parents informed.
- C. Monitor the client.
- D. Record the procedure.
Correct Answer: C
Rationale: Monitoring the child during conscious sedation ensures safety, detecting respiratory or cardiovascular changes promptly.
A 10-year-old child who is 5'4' (138 cm) tall with a history of asthma uses an inhaled bronchodilator only when needed. He takes no other medications routinely. His best peak expiratory flow rate is 270 L/minute. The child's current peak flow reading is 180 L/minute. The nurse interprets this reading as indicating which of the following?
- A. The child's asthma is under good control, so the routine treatment plan should continue.
- B. The child needs to start a short-acting inhaled beta-agonist medication.
- C. This is a medical emergency requiring a trip to the emergency department for treatment.
- D. The child needs to begin treatment with inhaled cromolyn sodium (Intal) for asthma control.
Correct Answer: B
Rationale: A peak flow reading of 180 L/minute is 66.7% of the child's best (270 L/minute), placing it in the yellow zone (50-80% of personal best), indicating an asthma exacerbation. A short-acting inhaled beta-agonist is needed to relieve symptoms.
Which of the following, if described by the parents of a child with cystic fibrosis (CF), indicates that the parents understand the underlying problem of the disease?
- A. An abnormality in the body's mucus-secreting glands.
- B. Formation of fibrous cysts in various body organs.
- C. Failure of the pancreatic ducts to develop properly.
- D. Addition to the formation of antibodies against streptococcus.
Correct Answer: A
Rationale: Cystic fibrosis is caused by an abnormality in mucus-secreting glands, leading to thick mucus that affects multiple organs, particularly the lungs and pancreas.