Nokea
A father asks the nurse how he would know if his child had developed mononucleosis. The nurse explains that in addition to fatigue, which of the following would be most common?
- A. Liver tenderness.
- B. Enlarged lymph glands.
- C. Persistent nonproductive cough.
- D. A blush-like generalized skin rash.
Correct Answer: B
Rationale: Enlarged lymph glands, especially in the neck, are a hallmark symptom of mononucleosis.
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A child is admitted with a diagnosis of possible appendicitis. The child is in acute pain. Which of the following nursing interventions would be appropriate prior to surgery to decrease pain? Select all that apply.
- A. Offer an ice pack.
- B. Apply a heating pad.
- C. Encourage the child to assume a position of comfort.
- D. Limit the child's activity.
- E. Request an order for a cathartic.
Correct Answer: A,C,D
Rationale: Ice, comfortable positioning, and activity limitation reduce pain; heating pads and cathartics may worsen appendicitis.
The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state:
- A. I should call if I see changes in the color of the toes under the cast.'
- B. I should use a pillow to elevate my child's foot as he sleeps.'
- C. My baby will need a series of casts to fix her foot.'
- D. Having a cast should not prevent me from holding my baby.'
Correct Answer: B
Rationale: Using a pillow to elevate the foot may alter the cast's corrective positioning, requiring additional teaching to avoid this practice.
What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of diphenylhydantoin (Dilantin)?
- A. Drinking plenty of fluids.
- B. Brushing teeth after each meal.
- C. Having someone be with the child during waking hours.
- D. Reporting signs of infection.
Correct Answer: B
Rationale: Dilantin can cause gingival hyperplasia; brushing after meals promotes oral hygiene to mitigate this side effect.
After teaching the mother of a child with severe burns about the importance of specific nutritional support in burn management, which of the following, if chosen by the mother from the child's diet menu, indicates the need for further teaching?
- A. Bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks.
- B. Cheeseburger, cottage cheese and pineapple salad, chocolate milk, and a brownie.
- C. Chicken nuggets, orange and grapefruit sections, and a vanilla milkshake.
- D. Beef, bean, and cheese burrito; a banana; fruit-flavored yogurt; and skim milk.
Correct Answer: A
Rationale: Burn patients require high-protein, high-calorie diets. Option A is low in protein and calories compared to options B, C, and D, which include protein-rich foods like cheese, chicken, and beans.
The mother of a 2-year-old is concerned because the child's right eye seems to turn in toward his nose when he is tired. The nurse should:
- A. Assure the mother that this is a normal event when the child is tired.
- B. Advise the mother to continue to watch his eyes closely and if the problem persists to call the clinic.
- C. Test the child with the cover-uncover test and refer to an ophthalmologist if the test is abnormal.
- D. Explain to the mother that the child will probably outgrow the weakness and she need not be concerned.
Correct Answer: C
Rationale: The cover-uncover test can detect strabismus, which requires referral if confirmed.