A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?
- A. Administer antibiotics as prescribed.
- B. Maintain the child on NPO status.
- C. Monitor the child's intake and output.
- D. Implement seizure precautions.
Correct Answer: D
Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety.
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A teacher states to the school nurse, 'I have a student who will often just stare at me for 15 seconds after asking a question; then the student blinks and asks me to repeat the question. Should I be concerned?' Which should the nurse include in the response to the teacher?
- A. The child has a crush on the teacher.
- B. The child has increased intracranial pressure.
- C. The child may have had a head injury.
- D. The child is experiencing absence seizures.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A child is being cared for by a nurse and has rheumatic fever. Which of the following actions should the nurse plan to take?
- A. Administer aspirin to the child as prescribed, based on the healthcare provider's instructions.
- B. Encourage adequate fluid intake for the child.
- C. Elevate the child's joints and provide warm compresses.
- D. Monitor the child's heart rate for dysrhythmias.
Correct Answer: D
Rationale: Rheumatic fever can lead to cardiac complications, such as dysrhythmias. Therefore, it is essential for the nurse to monitor the child's heart rate closely for any signs of dysrhythmias. This will help in early identification and prompt management of potential cardiac issues associated with rheumatic fever.
A healthcare provider is planning care for a child with hyperkalemia. Which manifestation associated with the documented hyperkalemia requires immediate intervention by the healthcare provider?
- A. Hyperthermia
- B. Respiratory distress
- C. Seizures
- D. Cardiac arrhythmias
Correct Answer: D
Rationale: In hyperkalemia, cardiac arrhythmias are the most critical and life-threatening manifestation that requires immediate intervention. Hyperkalemia can lead to dangerous heart rhythm disturbances, potentially resulting in cardiac arrest. Prompt treatment is essential to stabilize the heart rhythm and prevent life-threatening complications.
The child who walks alone, makes a tower of 3 cubes, inserts a raisin in a bottle, and identifies 1 or more parts of the body is
- A. 12 mo old
- B. 15 mo old
- C. 18 mo old
- D. 24 mo old
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is caring for a school-age child with primary nephrotic syndrome who is taking prednisone. After 1 week of treatment, which manifestation indicates to the nurse that the medication is effective?
- A. Decreased edema
- B. Increased abdominal girth
- C. Decreased appetite
- D. Increased protein in the urine
Correct Answer: A
Rationale: In a child with nephrotic syndrome, the presence of edema is due to fluid retention caused by protein loss in the urine. Prednisone, a corticosteroid, helps reduce inflammation and decrease the loss of protein in the urine, leading to a decrease in edema. Therefore, decreased edema is an indication that the prednisone treatment is effective in managing the nephrotic syndrome.
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