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A child with Graves' disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response?
- A. Increased weight gain
- B. Decreased heart rate
- C. Reduced headaches
- D. Diminished fatigue
Correct Answer: B
Rationale: The correct answer is B: 'Decreased heart rate.' Propranolol is a beta-blocker commonly used to manage symptoms of hyperthyroidism, including tachycardia. Monitoring for a decreased heart rate is important as it indicates the drug's therapeutic response in controlling the elevated heart rate associated with Graves' disease. Choices A, C, and D are incorrect because weight gain, reduced headaches, and diminished fatigue are not typical therapeutic responses to propranolol in the context of managing Graves' disease.
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The healthcare provider is caring for a 3-year-old child who is hospitalized with dehydration. The child is now receiving IV fluids and has started to produce urine. What is the best indicator that the child's dehydration is improving?
- A. The child's urine output has increased
- B. The child's skin turgor is normal
- C. The child's weight has increased
- D. The child's vital signs are stable
Correct Answer: A
Rationale: An increase in urine output is a reliable indicator that the child's hydration status is improving. Adequate urine output signifies that the kidneys are functioning properly and that the body is effectively eliminating waste and excess fluids, indicating improved hydration levels. The other options are not as direct indicators of hydration status. Skin turgor and weight changes can be influenced by various factors, and stable vital signs do not specifically reflect hydration status.
The healthcare provider is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective?
- A. Creamed corn.
- B. Pancakes.
- C. Rye crackers.
- D. Cooked oatmeal.
Correct Answer: A
Rationale: Creamed corn is a gluten-free food, making it a suitable option for clients with celiac disease. This choice indicates effective diet teaching as it aligns with the dietary restrictions necessary for managing the condition. Pancakes, rye crackers, and cooked oatmeal contain gluten, which is harmful to individuals with celiac disease. Therefore, they are not suitable choices and would not indicate effective teaching for a client with this condition.
The parents of a 9-month-old infant are being educated about preventing iron deficiency anemia. Which statement by the parent indicates a correct understanding of the teaching?
- A. I will start giving my baby whole cow's milk at 12 months
- B. I will give my baby iron-fortified cereal
- C. I will give my baby fruit juice between meals
- D. I will give my baby water with meals
Correct Answer: B
Rationale: The correct answer is B: 'I will give my baby iron-fortified cereal.' Iron-fortified cereal is an excellent source of iron for infants, aiding in the prevention of iron deficiency anemia. Choice A is incorrect as whole cow's milk should not be introduced until the child is at least 12 months old to prevent iron deficiency. Choice C is incorrect because giving fruit juice between meals can interfere with iron absorption. Choice D is incorrect as giving water with meals can decrease nutrient intake. Therefore, the best choice to prevent iron deficiency anemia in a 9-month-old infant is to give them iron-fortified cereal.
The healthcare provider is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant's clinical picture?
- A. Metabolic alkalosis.
- B. Respiratory acidosis.
- C. Metabolic acidosis.
- D. Respiratory alkalosis.
Correct Answer: A
Rationale: Pyloric stenosis leads to obstruction at the outlet of the stomach, causing frequent vomiting and loss of stomach acids. This results in a loss of hydrochloric acid and hydrogen ions, leading to metabolic alkalosis due to an increase in serum bicarbonate levels. Therefore, the correct answer is metabolic alkalosis. Choice B, respiratory acidosis, is incorrect as it is not typically associated with pyloric stenosis. Choice C, metabolic acidosis, is incorrect because the loss of stomach acids in pyloric stenosis leads to metabolic alkalosis, not acidosis. Choice D, respiratory alkalosis, is also incorrect as it is not the usual consequence of pyloric stenosis.
The healthcare provider is preparing to administer a vaccine to a 5-year-old child. The child is visibly anxious and asks if the shot will hurt. What is the healthcare provider's best response?
- A. It might hurt a little, but it will be over quickly
- B. It won't hurt at all, don't worry
- C. You're a big kid now, and big kids don't cry
- D. If you don't think about it, it won't hurt
Correct Answer: A
Rationale: When a child expresses fear or anxiety about receiving a vaccination, it is essential for the healthcare provider to provide honest and reassuring information. Choice A acknowledges the potential for some discomfort but also reassures the child that it will be over quickly. This response validates the child's feelings while also preparing them for the procedure. Choices B, C, and D either provide false reassurance, dismiss the child's feelings, or suggest avoidance, which are not appropriate responses in this situation.