Nokea
A child with Kawasaki disease is receiving low dose aspirin. The mother calls the clinic and states that the child has been exposed to influenza. Which recommendations should the nurse make?
- A. Increase fluid intake.
- B. Stop the aspirin.
- C. Keep the child home from school.
- D. Watch for fever.
- E. Weigh the child daily.
Correct Answer: B,C,D
Rationale: Aspirin should be stopped due to the risk of Reye's syndrome with influenza. Keeping the child home and monitoring for fever help manage infection risk.
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An adolescent sustains a T3 spinal cord injury. After insertion of an intravenous line, a nasogastric tube, and an indwelling urinary (Foley) catheter, the adolescent is admitted to the intensive care unit. What should the nurse do next when assessment reveals that the adolescent's feet and legs are cool to the touch?
- A. Cover the adolescent's legs with blankets.
- B. Report this finding to the physician immediately.
- C. Reposition the adolescent's legs.
- D. Lay the adolescent flat to aid circulation.
Correct Answer: A
Rationale: Cool extremities indicate poor circulation, common in spinal cord injury; covering with blankets promotes warmth and comfort.
The mother of a child with Duchenne's muscular dystrophy asks about the chance that her next child will have the disease. The nurse responds based on the understanding of which of the following?
- A. Sons have a 50% chance of being affected.
- B. Daughters have a 1 in 4 chance of being carriers.
- C. Each child has a 1 in 4 chance of developing the disease.
- D. Each child has a 50% chance of being a carrier.
Correct Answer: A
Rationale: Duchenne's muscular dystrophy is X-linked recessive, so sons of a carrier mother have a 50% chance of being affected, while daughters have a 50% chance of being carriers.
The nurse is teaching a group of parents about sickle cell anemia. Which statement by a parent indicates a need for further teaching?
- A. Sickle cell anemia is a genetic disorder.'
- B. Crises can be triggered by dehydration.'
- C. The disease only affects African Americans.'
- D. Oxygen therapy may be needed during a crisis.'
Correct Answer: C
Rationale: Sickle cell anemia affects various ethnic groups, not only African Americans. The other statements are accurate, indicating understanding.
The parents of an 18-year-old preparing to enter college ask if their daughter should have the meningococcal (MCV4) vaccine. The nurse should tell the parents:
- A. It is only necessary to have the vaccine if your daughter will be living in a dormitory.'
- B. We recommend the vaccine, but it needs to be given as a series of three injections.'
- C. Let's review your records. The vaccine may have already been given a few years ago.'
- D. We highly recommend this vaccine, but we will need to do a pregnancy screening first.'
Correct Answer: C
Rationale: Checking vaccination records confirms whether the MCV4 vaccine, recommended for adolescents, was previously administered.
When preparing to obtain a neonatal screening test for phenylketonuria (PKU), the neonate must have received which of the following to ensure reliable results?
- A. A feeding of an iron-rich formula.
- B. Nothing by mouth for 4 hours before the test.
- C. Initial formula or breast milk at least 24 hours before the test.
- D. A feeding of glucose water.
Correct Answer: C
Rationale: PKU screening requires protein intake (breast milk or formula) for 24 hours to detect elevated phenylalanine levels. Iron-rich formula, fasting, or glucose water are inadequate.