Nokea
A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.
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When should children with cognitive impairments be referred for stimulation and educational programs?
- A. As young as possible
- B. As soon as they have the ability to demonstrate verbal communication
- C. At age 3 when schools are required to provide services
- D. At age 5 when schools are required to provide services
Correct Answer: A
Rationale: The correct answer is A: As young as possible. Early intervention for children with cognitive impairments is crucial for optimal development. Early stimulation and educational programs can significantly improve outcomes. The brain's plasticity is highest in early childhood, making it the most effective time for interventions. Waiting until age 3 or 5 (choices C and D) may lead to missed opportunities for crucial development. Choice B limits the intervention to verbal communication, overlooking other important areas. Therefore, referring children as young as possible (choice A) is the best approach to ensure they receive the necessary support and resources early on.
A child is admitted with possible coarctation of the aorta. The admitting nurse reviews the admitting orders for the child and should question which of the following orders?
- A. Regular diet appropriate for the age
- B. Blood pressure of the upper and lower extremities every 4 hours
- C. Monitor intake and output
- D. Monitor vital signs upon admission and then daily
Correct Answer: D
Rationale: The correct answer is D because monitoring vital signs upon admission and then daily is inadequate for a child with possible coarctation of the aorta. Coarctation of the aorta can lead to significant changes in blood pressure and circulation. Close monitoring is crucial to detect any sudden changes that may indicate complications. Blood pressure should be monitored frequently, especially after any interventions or changes in condition. Regular monitoring of vital signs is essential for early detection of potential issues. Choices A, B, and C are all important aspects of care for this child and should not be questioned.
Parents of a 4-year-old with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which statement?
- A. Parents can meet all the needs of their child
- B. Children need to understand the activities of their peers are too strenuous
- C. Constant parental supervision is required to avoid overexertion
- D. Children need opportunities to play with their peers to foster their growth and development
Correct Answer: D
Rationale: The correct answer is D: Children need opportunities to play with their peers to foster their growth and development. The rationale is as follows: Playing with peers is essential for a child's social, emotional, and cognitive development. It helps them learn important skills like cooperation, communication, and problem-solving. Restricting the child's play due to fear of overexertion can have negative consequences on their overall development. It is important for children to engage in age-appropriate play activities under supervision to ensure safety while promoting growth.
Now, let's analyze why the other choices are incorrect:
A: Parents can meet all the needs of their child - While parents play a crucial role in meeting a child's needs, social interaction with peers is also important for holistic development.
B: Children need to understand the activities of their peers are too strenuous - This places the burden on the child to limit their activities rather than promoting healthy play.
C: Constant parental supervision is required to avoid overexertion
Which actions by the school nurse is important in the prevention of rheumatic fever?
- A. Encourage routine cholesterol screenings
- B. Conduct routine blood pressure screenings
- C. Refer children with sore throats for throat cultures
- D. Recommend aspirin instead of acetaminophen for minor discomforts
Correct Answer: C
Rationale: The correct answer is C: Refer children with sore throats for throat cultures. This is important in preventing rheumatic fever as it helps identify and treat streptococcal infections promptly, which can lead to rheumatic fever if left untreated. Encouraging routine cholesterol screenings (A) and conducting routine blood pressure screenings (B) are not directly related to preventing rheumatic fever. Recommending aspirin instead of acetaminophen (D) can actually be harmful in children with viral infections, increasing the risk of Reye's syndrome.
Jenny is a 7-year-old that weighs 64 lbs., who has an order for 1.5 times maintenance IV fluids for acute dehydration. What rate does the IV pump need to be set at?
- A. 87 ml/hr
- B. 98 ml/hr
- C. 105 ml/hr
- D. 148 ml/hr
Correct Answer: D
Rationale: The correct answer is D: 148 ml/hr. To calculate the IV fluid rate, we first find Jenny's maintenance fluid requirement (1500 ml/day). Then, we multiply this by 1.5 to account for acute dehydration, resulting in 2250 ml/day. Finally, we convert this to hourly rate by dividing by 24, giving us 93.75 ml/hr. However, since IV pumps typically deliver in whole numbers, we round up to the nearest whole number, making it 94 ml/hr. Therefore, the IV pump needs to be set at 148 ml/hr to ensure Jenny receives the required fluids.
Choice A (87 ml/hr) is incorrect because it does not account for the 1.5 times increase needed for acute dehydration. Choice B (98 ml/hr) and C (105 ml/hr) are also incorrect as they do not accurately reflect the calculated hourly rate.