Nokea
A nurse is caring for a prenatal client who has parvovirus B19 (fifth disease). Which of the following actions should the nurse take?
- A. Administer antiviral medication
- B. Schedule an ultrasound examination
- C. Administer Haemophilus influenza type b vaccine
- D. Schedule an indirect Coombs’ test
Correct Answer: B
Rationale: The correct answer is B: Schedule an ultrasound examination. Parvovirus B19 in pregnancy can lead to complications such as fetal hydrops. An ultrasound can monitor fetal well-being and detect any abnormalities. Administering antiviral medication (A) is not typically recommended for parvovirus B19. Administering the Haemophilus influenza type b vaccine (C) is unrelated to this condition. Performing an indirect Coombs' test (D) is used to detect maternal antibodies in Rh incompatibility, not related to parvovirus B19.
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Which assessment finding indicates that placental separation has occurred during the third stage of labor?
- A. Decreased vaginal bleeding
- B. Contractions stop
- C. Maternal shaking and chills
- D. Lengthening of the umbilical cord
Correct Answer: D
Rationale: The correct answer is D: Lengthening of the umbilical cord. This indicates placental separation as the placenta detaches from the uterine wall, causing the cord to lengthen. A: Decreased vaginal bleeding is incorrect as bleeding typically increases due to separation. B: Contractions stopping is not indicative of placental separation but can occur after the placenta is delivered. C: Maternal shaking and chills are signs of postpartum shivering, not placental separation.
Which of the following emotional manifestations demonstrates an improvement in a 7-month-old infant diagnosed with nonorganic failure to thrive?
- A. Infant has no fear of strangers.
- B. Infant scans environment with wide-eyed gaze.
- C. Infant is passive and sleeps well.
- D. Infant likes to be held and touched.
Correct Answer: D
Rationale: The correct answer is D: Infant likes to be held and touched. This demonstrates an improvement in the infant's emotional well-being as it shows an attachment behavior, indicating a sense of security and trust. Infants with nonorganic failure to thrive often exhibit social withdrawal and disinterest in physical contact. Choice A is incorrect as it describes a lack of stranger anxiety, which is not necessarily indicative of improvement in this context. Choice B is incorrect as a wide-eyed gaze could indicate vigilance or anxiety rather than positive emotional development. Choice C is incorrect as passivity and good sleep are not specific indicators of emotional improvement. In summary, choice D is the correct answer as it reflects positive emotional progress in the infant's attachment and responsiveness to touch.
A nurse is reinforcing teaching to a group of parents about preventing accidental poisoning in preschoolers. Which of the following should the nurse include?
- A. Have syrup of ipecac available in the home.
- B. Explain to preschool children that plants can be eaten only after they are cooked.
- C. Keep labels on containers of toxic substances and never remove them.
- D. Place medications in a cabinet above the sink.
Correct Answer: C
Rationale: The correct answer is C: Keep labels on containers of toxic substances and never remove them. This is important to prevent accidental poisoning in preschoolers as it helps parents and caregivers easily identify and differentiate toxic substances from safe ones. Removing labels can lead to confusion and increase the risk of accidental ingestion. Having syrup of ipecac available (choice A) is no longer recommended as a first-aid treatment for poisoning. Teaching children to cook plants before eating them (choice B) is not a practical or safe approach. Placing medications in a cabinet above the sink (choice D) may not be effective as preschoolers can still access them if the cabinet is not securely locked.
Which is the recommended treatment for moderate to severe lead poisoning?
- A. IV fluids
- B. Antiemetics
- C. Heavy metal antagonist
- D. Antibiotics
Correct Answer: C
Rationale: The heavy metal antagonist, edetate calcium disodium, is frequently the drug of choice for the removal of the lead toxin from the body. Chelating agents inactivate the toxicity of the lead and cause excretion through the urine. IV fluids, antiemetics, and antibiotics do not address the core issue of removing lead from the body.
A nurse on a pediatric unit is assigned to care for a child with Reye syndrome. Which of the following is the most serious clinical manifestation for which the nurse should monitor?
- A. Anaphylaxis
- B. Cerebral edema
- C. Impaired coagulation
- D. Hypervolemia
Correct Answer: B
Rationale: The correct answer is B: Cerebral edema. In Reye syndrome, cerebral edema is the most serious manifestation due to increased intracranial pressure, potentially leading to brain damage or death. Anaphylaxis (A) is not typically associated with Reye syndrome. Impaired coagulation (C) can occur but is not as immediately life-threatening as cerebral edema. Hypervolemia (D) is a possible complication but not as critical as cerebral edema in Reye syndrome.