Nokea
A mother brings her 3-month-old infant to the clinic, concerned about frequent vomiting after feeding. The practical nurse (PN) suspects gastroesophageal reflux (GER). Which recommendation should the PN provide to the mother?
- A. Feed the infant in a prone position.
- B. Provide larger, less frequent feedings.
- C. Keep the infant upright for 30 minutes after feeding.
- D. Offer only formula thickened with rice cereal.
Correct Answer: C
Rationale: The correct recommendation for reducing symptoms of gastroesophageal reflux (GER) in infants is to keep the infant upright for 30 minutes after feeding. This position helps prevent the backflow of stomach contents, alleviating symptoms of reflux. Placing the infant in a prone position or providing larger, less frequent feedings may worsen symptoms, while offering only formula thickened with rice cereal is not the first-line intervention for GER.
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A male adolescent who is newly diagnosed with a seizure disorder receives a prescription for an anticonvulsant. Which statement indicates the client is at risk for non-compliance with life-long medication management?
- A. I hope I will be able to drive while taking these pills.
- B. My friends will think I am a freak if I take these pills.
- C. I don't want my parents monitoring my medications.
- D. I will take the pills at home so others will not see me.
Correct Answer: B
Rationale: The statement 'My friends will think I am a freak if I take these pills' indicates concerns about peer perception, which can lead to non-compliance in adolescents. Peer pressure and fear of social stigma can significantly impact medication adherence in this age group, making option B the most concerning response regarding the client's compliance with life-long medication management.
What information should the nurse provide to parents of a 3-year-old boy with Duchenne muscular dystrophy who inquire about the disease and future children?
- A. This is an inherited X-linked recessive disorder, which primarily affects male children in the family
- B. The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers
- C. The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred
- D. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles
Correct Answer: A
Rationale: Duchenne muscular dystrophy is an X-linked recessive disorder caused by mutations in the DMD gene on the X chromosome. This disorder primarily affects males because they have one X chromosome, inherited from their mothers, who may be carriers of the mutated gene. Females have two X chromosomes, providing a protective effect as the normal gene on one X chromosome can compensate for the mutated gene on the other. Therefore, the nurse should explain to the parents that Duchenne muscular dystrophy is an inherited X-linked recessive disorder, which is why their son has the disease and why there is a risk of passing it on to future sons.
The heart rate for a 3-year-old with a congenital heart defect has steadily decreased over the last few hours, now it's 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider?
- A. Oxygen saturation 94%.
- B. RR of 25 breaths/minute.
- C. Urine output 20 mL/hr.
- D. BP 70/40.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin). What intervention should the nurse implement first?
- A. Administer activated charcoal
- B. Prepare gastric lavage
- C. Obtain a 12-lead electrocardiogram
- D. Give IV digoxin immune fab (Digibind)
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a 4-year-old child who has been diagnosed with measles. Which intervention should the nurse implement to prevent the spread of infection?
- A. Administer antipyretics as prescribed
- B. Place the child in airborne isolation
- C. Encourage fluid intake
- D. Teach the parents about hand hygiene
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.