Nokea
A nurse explains to a child's parents that the role of methotrexate (Rheumatrex®) in treating children with juvenile arthritis is to:
- A. decrease the inflammatory response.
- B. improve functional ability.
- C. control the febrile response.
- D. minimize the effects of uveitis.
Correct Answer: A
Rationale: Methotrexate, which is a disease-modifying antirheumatic drug (DMARD), is commonly used to treat juvenile arthritis by decreasing the inflammatory response in the joints. By suppressing the overactive immune response that causes inflammation in the joints, methotrexate helps reduce pain, swelling, and stiffness in children with juvenile arthritis. This ultimately helps to improve joint function and prevent joint damage. While methotrexate may indirectly contribute to improving functional ability and controlling febrile responses in some cases, its primary mechanism of action is to target and reduce inflammation in juvenile arthritis. The medication may also help in managing associated conditions like uveitis, but its main role lies in decreasing the inflammatory response in arthritis.
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The entire process of toilet training need not be hurried and it can take
- A. 2 months
- B. 4 months
- C. 6 months
- D. 8 months
Correct Answer: C
Rationale: Toilet training typically takes around 6 months, though this varies from child to child.
A child has a postoperative appendectomy incision covered by a dressing. The nurse has just completed a prescribed dressing change for this child. Which description is an accurate documentation of this procedure?
- A. Dressing change to appendectomy incision completed, child tolerated procedure well, parent present
- B. No complications noted during dressing change to appendectomy incision
- C. Appendectomy incision non-reddened, sutures intact, no drainage noted on old dressing, new dressing applied, procedure tolerated well by child
- D. No changes to appendectomy incisional area, dressing changed, child complained of pain during procedure, new dressing clean, dry and intact
Correct Answer: C
Rationale: Option C provides a thorough and accurate documentation of the dressing change procedure for the postoperative appendectomy incision. This documentation includes essential details such as the condition of the incision site (non-reddened, sutures intact, no drainage noted on old dressing), the action taken (new dressing applied), and the outcome (procedure tolerated well by the child). It covers all the necessary aspects of the dressing change procedure and clearly indicates the status of the incision site before and after the intervention. Options A, B, and D do not provide as comprehensive and detailed information about the dressing change procedure and its outcomes, making option C the most appropriate choice for accurate documentation.
Jose is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
- A. Directed at his parents because he is too young to understand
- B. Detailed in regard to the actual procedures so he will know what to expect
- C. Done several days before the procedure so that he will be prepared
- D. Adapted to his level of development so that he can understand
Correct Answer: D
Rationale: Preoperative teaching for Jose, a 4-year-old child, scheduled for a cardiac catheterization should be adapted to his level of development so that he can understand. Children at this age have limited cognitive and emotional understanding, so using simple language, visuals, and play-based strategies is essential. It is important to provide age-appropriate information to reduce anxiety and improve cooperation during the procedure. Preoperative teaching should focus on preparing Jose for what he will see, hear, and experience in a way that is tailored to his developmental stage. Involving play tools such as medical play dolls or child-friendly illustrations can help Jose grasp the concept of the procedure and alleviate fears. It is important to involve both Jose and his parents in the teaching process to ensure they understand how to support and prepare him for the procedure.
A worried mother of a 4-year-old boy describes attacks of inconsolable crying and prefers to play alone. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: B
Rationale: Further history is needed to rule out behavioral or psychological issues.
Airborne isolation is required for a child who is hospitalized with:
- A. mumps.
- B. chickenpox.
- C. exanthema subitum (roseola).
- D. erythema infectiosum (fifth disease).
Correct Answer: B
Rationale: Airborne isolation is needed for a child hospitalized with chickenpox (varicella) because the virus causing chickenpox spreads easily through the air when an infected person coughs or sneezes. The virus can also be transmitted through direct contact with the rash or fluid from the blisters. By implementing airborne precautions, healthcare providers aim to prevent the spread of the virus to other patients, staff, and visitors in the healthcare setting. In contrast, mumps, exanthema subitum (roseola), and erythema infectiosum (fifth disease) are generally not transmitted through airborne routes; therefore, they do not require airborne isolation in a hospital setting.