Nokea
A nurse is assisting with the care of a hospitalized toddler who has congenital heart disease. The parent calls the nurse to the room to ask for fresh linens and states, 'My child never wets the bed at home. I am not sure why this is happening now.' Which of the following responses should the nurse make to the parent?
- A. I know this must be embarrassing for you. I have kids myself, and I would be concerned, too.
- B. Regression is a common reaction to stress when toddlers are hospitalized. This is temporary.
- C. Your child appears to be just fine. If they aren't worried about it, then you shouldn't be either.
- D. I will talk to the provider about this. It could indicate worsening of your child's condition.
Correct Answer: B
Rationale: Regression like bedwetting is common during hospitalization stress and is typically temporary. Other responses either dismiss concerns or unnecessarily escalate the issue.
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A nurse is preparing to percuss an adolescent's chest and abdomen. Which of the following areas should the nurse expect to hear a dull sound?
- A. This region of the chest is expected to be resonant on percussion because of the air in the lung.
- B. The right upper quadrant of the abdomen is usually dull on percussion because of the underlying liver.
- C. This site is tympanic because of the gas in the intestines.
Correct Answer: B
Rationale: The right upper quadrant is dull due to the liver. The chest is resonant, and intestines are tympanic.
A nurse is assisting with the care of a child who is in status asthmaticus. Which of the following medications should the nurse administer first?
- A. Heliox via inhalation
- B. Albuterol via nebulizer
- C. Prednisone by mouth
- D. 0.9% sodium chloride via IV bolus
Correct Answer: B
Rationale: Albuterol rapidly relieves bronchospasm in status asthmaticus. Heliox, prednisone, and saline are secondary or not indicated as first-line treatments.
A nurse is assisting with providing care for an adolescent client who has neuropathic pain. Which of the following medications should the nurse anticipate administering?
- A. Oxycodone
- B. Gabapentin
- C. Acetaminophen
- D. Duloxetine
Correct Answer: B
Rationale: Gabapentin is effective for neuropathic pain by modulating nerve activity. Oxycodone and acetaminophen are less specific, and duloxetine is not first-line for adolescents.
A nurse in a provider's office is collecting data from an adolescent who has juvenile idiopathic arthritis and has been taking ibuprofen daily for the last 6 months. Which of the following client statements should the nurse report to the provider?
- A. I have morning stiffness in my joints.
- B. I have been taking a multivitamin that contains iron.
- C. I noticed some blood in my stool this morning.
- D. I skipped taking my ibuprofen last week after I went swimming.
Correct Answer: C
Rationale: Blood in stool suggests possible GI bleeding from long-term ibuprofen use, requiring urgent reporting. Stiffness is expected, vitamins are benign, and a single missed dose is less critical.
A nurse is assisting in the admission of a 9-month-old infant who has gastroenteritis with vomiting and diarrhea. Which of the following findings is the nurse's priority?
- A. Skin turgor
- B. Potassium level
- C. Capillary refill
- D. Heart rate
Correct Answer: D
Rationale: The elevated heart rate (tachycardia) at 182/min indicates increased cardiac workload, likely due to dehydration from gastroenteritis, requiring immediate attention. While skin turgor, potassium levels, and capillary refill are important, tachycardia is the priority to stabilize the infant.