Nokea
A nurse is caring for a toddler who has acute lymphocytic leukemia. In which of the following activities should the nurse expect the child to participate?
- A. Using scissors to cut out paper shapes
- B. Playing with a large plastic truck
- C. Looking at alphabet flash cards
- D. Watching a cartoon in the activity room
Correct Answer: D
Rationale: The correct answer is D: Watching a cartoon in the activity room. Toddlers with acute lymphocytic leukemia are often immunocompromised, making them susceptible to infections. Therefore, activities that involve potential injury or exposure to germs, such as using scissors (choice A) or playing with toys that cannot be easily cleaned (choice B) should be avoided. Looking at alphabet flash cards (choice C) may be mentally stimulating but does not address the safety concerns. Watching a cartoon in the activity room (choice D) is a safe and enjoyable activity that can help keep the child entertained without posing a risk of injury or infection.
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A nurse is assessing a school-age child who is receiving morphine. For which of the following adverse effects should the nurse monitor?
- A. Hypertension
- B. Bradypnea
- C. Stevens-Johnson syndrome
- D. Prolonged wound healing
Correct Answer: B
Rationale: The correct answer is B: Bradypnea. Morphine is an opioid that can cause respiratory depression, leading to bradypnea (slow breathing). The nurse should monitor the child's respiratory rate regularly as a safety precaution. Hypertension (A), Stevens-Johnson syndrome (C), and prolonged wound healing (D) are not typically associated with morphine use in school-age children. Monitoring for these adverse effects would not be a priority in this situation.
A nurse is caring for an infant who has necrotizing enterocolitis. Which of the following findings should the nurse expect?
- A. Hypertension
- B. Rounded abdomen
- C. Vomiting
- D. Tachypnea
Correct Answer: B,C,D
Rationale: The correct answer is B, C, and D. Necrotizing enterocolitis (NEC) in infants commonly presents with a rounded abdomen due to abdominal distension (B). Vomiting (C) is also a common symptom associated with NEC. Tachypnea (D) may occur due to abdominal distension and sepsis. Hypertension (A) is not typically associated with NEC in infants. The other choices are not provided, but based on typical NEC symptoms, they would not be expected in a patient with this condition.
A nurse is teaching a parent of a school-age child who is to begin a daily dose of methylphenidate. Which of the following should the nurse include in the teaching?
- A. Your child should avoid excess sodium intake.
- B. You should administer the medication at bedtime.
- C. Your child should avoid foods containing tyramine.
- D. You should administer the medication after breakfast.
Correct Answer: D
Rationale: The correct answer is D: You should administer the medication after breakfast. Methylphenidate is a stimulant medication commonly used to treat attention deficit hyperactivity disorder (ADHD). Administering it after breakfast helps to minimize potential side effects like decreased appetite and insomnia. It also ensures the medication's effectiveness during the child's school hours. Choice A is incorrect as sodium intake is not specifically contraindicated with methylphenidate. Choice B is incorrect as administering the medication at bedtime can interfere with the child's sleep. Choice C is incorrect as tyramine is not a concern with methylphenidate.
A nurse is planning postoperative care for an adolescent following scoliosis repair with spinal instrumentation. Which of the following actions should the nurse include in the plan of care?
- A. Maintain the head of the bed at a 30° angle.
- B. Offer sips of water due to having surgery.
- C. Log roll the adolescent every 2 hours.
- D. Assist the adolescent to ambulate 12 hours following surgery.
Correct Answer: C
Rationale: The correct answer is C: Log roll the adolescent every 2 hours. This is important to prevent pressure ulcers and maintain spinal alignment post-surgery. Log-rolling involves turning the patient as a unit to avoid twisting the spine. Maintaining the head of the bed at a 30° angle (choice A) is important for respiratory function but not specific to spinal surgery. Offering sips of water (choice B) is generally appropriate after surgery but not specific to spinal instrumentation. Assisting the adolescent to ambulate (choice D) should be done gradually and with caution, typically starting with sitting on the bedside first, rather than a fixed time frame like 12 hours post-surgery.
A nurse is assessing a child who has measles. Which of the following areas should the nurse inspect for Koplik spots?
Correct Answer: C
Rationale: The correct answer is C. Koplik spots are small, white, grain-like spots with a red halo that appear on the buccal mucosa opposite the molars. They are specific to measles and typically appear 2-4 days before the rash. Inspecting other areas like the skin (choice A), scalp (choice B), nails (choice D), ears (choice E), throat (choice F), or feet (choice G) would not reveal Koplik spots as they are only found in the mouth. Therefore, choice C is the correct option for assessing Koplik spots in a child with measles.