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A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?
- A. Administer 100% oxygen to relieve hypoxia
- B. Administer pain medication to relieve symptoms
- C. Notify the practitioner because chest syndrome is suspected
- D. Notify the practitioner because the child may be having a stroke
Correct Answer: C
Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.
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A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?
- A. We should give this drug after he eats something.
- B. We need to watch carefully for possible infections.
- C. The drug should not be stopped abruptly.
- D. He might experience weight gain with this drug.
Correct Answer: A
Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.
A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?
- A. Feeding problems are common in neonates.
- B. Inadequate sucking is not significant unless cyanosis is present.
- C. Ineffective sucking and swallowing may be early indications of a heart defect.
- D. Many neonates retain mucus, which can interfere with feeding for several weeks.
Correct Answer: C
Rationale: Ineffective sucking and swallowing can be early signs of a heart defect like a ventricular septal defect. This is crucial information for the nurse to consider as it aligns with the infant's tentative diagnosis. Choice A is too general and does not provide specific relevance to the situation. Choice B is incorrect as inadequate sucking can indeed be significant, especially in the context of a potential heart defect. Choice D is not directly related to the potential heart defect and feeding difficulties mentioned in the scenario.
What should the nurse suggest to a parent asking for advice on managing their child's earache and fever?
- A. Applying a warm compress to the affected ear
- B. Giving the child a cold drink
- C. Administering acetaminophen
- D. Taking the child to the emergency department
Correct Answer: A
Rationale: The correct answer is to suggest applying a warm compress to the affected ear. This can help alleviate pain and discomfort associated with the earache. Giving a cold drink (Choice B) may not address the underlying issue and is not a recommended treatment for earaches. Administering acetaminophen (Choice C) can help reduce fever but may not directly target the earache. Taking the child to the emergency department (Choice D) is usually not necessary for a common earache unless there are severe symptoms or complications present.
A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?
- A. suction the oropharynx
- B. insert a nasopharyngeal airway
- C. initiate positive pressure ventilations
- D. place the patient in the recovery position
Correct Answer: A
Rationale: In this scenario, the 4-year-old is presenting with signs of airway compromise due to the fall. After performing a jaw-thrust maneuver to open the airway while stabilizing the head to prevent further injury, the next step should be to suction the oropharynx. Suctioning helps to clear any blood or secretions from the mouth and throat, ensuring a clear airway for proper breathing. Inserting a nasopharyngeal airway or initiating positive pressure ventilations would be premature without first ensuring the airway is clear. Placing the patient in the recovery position is not indicated at this point as the focus should be on managing the airway.
A 5-year-old child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?
- A. Assess the child's sleep patterns
- B. Assess the child's dietary intake
- C. Assess the child's academic performance
- D. Assess the child's behavior at home
Correct Answer: B
Rationale: Assessing the child's dietary intake is crucial for managing asthma symptoms as certain foods can trigger or worsen asthma attacks. Monitoring dietary intake helps ensure the child receives proper nutrition and avoids triggers. Assessing sleep patterns (Choice A) may be relevant but not as directly impactful on asthma management. Academic performance (Choice C) and behavior at home (Choice D) are important aspects of a child's overall health but are not as directly related to asthma management as dietary intake.