A nurse is caring for a child with Down syndrome. Which statement by the parent indicates the need for further teaching?
- A. I will make sure my child has regular hearing screenings.
- B. I will encourage my child to be active and participate in play.
- C. I should monitor my child's thyroid function regularly.
- D. I should avoid giving my child a multivitamin supplement.
Correct Answer: D
Rationale: Children with Down syndrome may benefit from a multivitamin supplement, especially if they are at risk for nutritional deficiencies.
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During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond?
- A. Ask for a demonstration of these exercises
- B. Explain that coughing should be avoided
- C. Review the client’s previous surgical history
- D. Document the client's understanding of teaching
Correct Answer: A
Rationale: Asking for a demonstration ensures that the client understands the proper technique for coughing and deep breathing exercises.
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin (Lanoxin). Which statement by the parent indicates a need for further instruction?
- A. “If my child vomits after the medication administration, I will repeat the dose.â€
- B. “I will not mix the medication with food.â€
- C. “I will take my child’s pulse before administering the medication.â€
- D. “If more than one dose is missed, I will call the provider.â€
Correct Answer: A
Rationale: Repeating the dose after vomiting can lead to digoxin toxicity, which is dangerous. The parent should be instructed to contact the healthcare provider if vomiting occurs after administration.
A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess:
- A. Pain
- B. Pulses
- C. Hemoglobin and hematocrit levels
- D. Catheterization report
Correct Answer: B
Rationale: Checking pulsesâ€â€especially in the canulated extremityâ€â€assures perfusion to that extremity and is the priority postprocedure.
The most appropriate first-line treatment for status epilepticus in a child is:
- A. Diazepam
- B. Phenytoin
- C. Carbamazepine
- D. Valproate
Correct Answer: A
Rationale: Diazepam is commonly used as the first-line treatment in managing status epilepticus due to its fast-acting, long-lasting anticonvulsant effects.
The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.